Plain English Summary
Background and study aims:
Nearly one-in-three people choose to see a dentist only when they have a dental problem, such as toothache or abscess. Urgent dental treatment is focused on addressing pain and stabilising the problem; it is usually delivered within high-street dental practices or out-of-hours dental clinics. According to clinical guidelines, optimal treatment for urgent dental problems usually involves an intervention, such as extraction of a tooth. Prescription-only treatment plans, such as for painkillers or antibiotics, are rarely indicated. Published research provides some evidence (from interviews with clinicians) to explain why provision of urgent dental care often does not comply with clinical guidelines. The aim of this study is to identify what factors in dentist-patient interactions influence treatment during actual urgent dental appointments.
Who can participate?
Adults attending an urgent NHS dental appointment (and chaperone if used) and the clinician treating them.
What does the study involve?
All patients attend their appointments as they usually would. Each appointment is audio-recorded and the clinicians are asked to complete short questionnaires after each one. In-depth study of a selection of cases involves analysis of the recordings, observation notes and questionnaires, together with follow-up interviews with patients and clinicians.
What are the possible benefits and risks of participating?
There are no direct benefits for patient or chaperone participants; clinicians will be reimbursed for the time taken delivering the study which is in excess of time spent normally treating patients. There are no direct risks involved with participating.
Where is the study run from?
Six General Dental Practices and two Unscheduled Dental Care clinics across Lancashire and West Yorkshire (UK)
When is study starting and how long is it expected to run for?
October 2015 to March 2018
Who is funding the study?
National Institute for Health Research (UK)
Who is the main contact?
Ms Wendy Thompson
dnwt@leeds.ac.uk
Trial website
Contact information
Type
Public
Primary contact
Ms Wendy Thompson
ORCID ID
http://orcid.org/0000-0001-6799-4087
Contact details
School of Dentistry
University of Leeds
Worsley Building
Clarendon Way
Leeds
LS2 9JT
United Kingdom
+44 113 343 9214
dnwt@leeds.ac.uk
Additional identifiers
EudraCT number
ClinicalTrials.gov number
Protocol/serial number
32833
Study information
Scientific title
Which factors in dentist-patient interactions influence treatment in urgent dental care?
Acronym
TRUCE
Study hypothesis
The aim of this study is to assess which factors in dentist-patient interactions influence treatment in urgent dental care.
Ethics approval
Bradford/Leeds REC, 09/02/2017, ref: 16/YH/0487
Study design
Observational; Design type: Qualitative
Primary study design
Observational
Secondary study design
Cross sectional study
Trial setting
GP practices
Trial type
Other
Patient information sheet
Not available in web format, please use the contact details below to request a patient information sheet
Condition
Specialty: Oral and dental health, Primary sub-specialty: Oral and dental public health; UKCRC code/ Disease: Oral and Gastrointestinal/ Diseases of oral cavity, salivary glands and jaws
Intervention
Patient participants will be recruited when they present for urgent dental care appointments. Following initial consent (from the patient and also anyone else who they bring with them into the appointment), appointments will be observed and/or audiorecorded. Urgent NHS dental appointments usually take between 10 and 20 minutes. Patients may be contacted (up to three months after their appointment) for follow-up telephone interview which will last around 30 minutes.
Clinician participants (dentists and dental nurses) will be observed/audio-recorded during 16 dental appointment. At the end of each appointment, each clinician will complete a very short questionnaire (taking less than 30 seconds). Follow-up telephone interview with a selection of the clinicians will also take place up to three months after the appointments.
Intervention type
Other
Phase
Drug names
Primary outcome measure
Identification of factors in the dentist:patient interaction which influence urgent dental treatment, through analysis of transcripts of urgent dental appointments; observation field notes, clinician questionnaires and Interviews with patients and clinicians.
Secondary outcome measures
No secondary outcome measures
Overall trial start date
01/10/2015
Overall trial end date
31/03/2018
Reason abandoned (if study stopped)
Eligibility
Participant inclusion criteria
Patient Participant Inclusion Criteria:
1. Aged over 18 years
2. Attending an urgent NHS dental appointment
3. Able and willing to provide valid consent to participate in the research
Chaperone Participant Inclusion Criteria
1. Aged over18 years
2. In attendance during an urgent NHS dental appointment
3. Able and willing to provide valid consent to participate in the research
Clinician Participant Inclusion Criteria:
1. Registered with the GDC
2. Professional indemnity is in place and covers any activity undertaken during the course of this research, including any harm to participants in the conduct of the research
3. Willing to provide valid consent to participate in the research
Participant type
Patient
Age group
Adult
Gender
Both
Target number of participants
Planned Sample Size: 192; UK Sample Size: 192
Participant exclusion criteria
Patient Participant Exclusion Criteria:
1. Currently experiencing severe or debilitating pain or distress
2. Attending for routine dental treatment
3. Attending for private dental treatment
4. Accompanied during their appointment by a chaperone who is a minor (< 18 years)
5. Accompanied during their appointment by a chaperone who is not able and willing to provide valid consent to participate in the research.
Clinician Participant Exclusion Criteria:
1. Provides only private dental treatment to adult patients
2. Currently subject to any condition on their registration (including from the NHS England Area Team and the General Dental Council). Any registrant who subsequently becomes subject to any condition during the course of the research will agree to notify the CI in a timely fashion.
Recruitment start date
30/05/2017
Recruitment end date
31/08/2017
Locations
Countries of recruitment
United Kingdom
Trial participating centre
Bradford District Care NHS Foundation Trust
New Mill
Victoria Road
Bradford
BD18 3LD
United Kingdom
Funders
Funder type
Government
Funder name
National Institute for Health Research
Alternative name(s)
NIHR
Funding Body Type
government organisation
Funding Body Subtype
Federal/National Government
Location
United Kingdom
Results and Publications
Publication and dissemination plan
The final study report will form part of the Chief Investigator’s PhD thesis which will be made publically available through the British Library’s EThOS (e-Theses Online Service) database; it is anticipated that this will be during 2019. Publications by the CI in high-quality, peer-reviewed dental journals are also planned in a similar timeframe. A Plain English summary of research findings will be prepared at the end of the study and made available for participating practices, clinicians, patients (who have given contact details for this during the consent process) and other patient advocacy organisations interested in the research.
IPD sharing statement:
The datasets generated during and/or analysed during the current study are/will be available upon request from Research Data Leeds.
Intention to publish date
31/12/2019
Participant level data
Not provided at time of registration
Basic results (scientific)
Publication list