Provision of specialist-led minor oral surgery service in Scottish NHS dental practices - analysis of benefits and costs

摘要

This article evaluates the benefits of specialist-led minor oral surgery service in Scottish primary care dental practice. Objectives: The aims of the study were to: 1 Study practice-based minor oral surgery service delivery. 2 Estimate waiting times for these patients. 3 Explore complications. 4 Evaluate cost allocated for procedures in minor oral surgery in primary and secondary sector. Materials and Methods: Retrospective analysis of procedures carried out, waiting times, complications and comparative cost in minor oral surgery from two NHS dental practices located in Lothian health board area. Results: A total of 1896 procedures in 982 patients having minor oral surgery were analysed across two sites. Of procedures, 51 (971) were simple extractions; 31 (580) of the procedures were surgical removal of non-third molar teeth; 15 (275) of the procedures were surgical extraction of third molars; and 3 (70) of the procedures were complex procedures such as surgical exposure of canines, removal of simple cysts and closure of oroantral communication. Two hundred and nine procedures were carried out under intravenous sedation. It was difficult to estimate waiting times although all patients were treated within 4 weeks. The overall complication rate was 8.1. There is a considerable difference in cost allocated to similar procedures in primary and secondary care and the money allocated for carrying out minor oral surgery in primary care is not cost neutral. Conclusions: It is cost efficient to treat minor oral surgery patients in primary care. Like for like procedures in minor oral surgery are expensive and potentially wait longer before receiving treatment in secondary care.