Title : An audit exploring the compliance in the general dental practice setting to taking radiographs in the paediatric population
Abstract:
Radiographs are universally acceptable, in adjunct with clinical findings, to aid accurate and early dental caries diagnoses, particularly in higher risk children. Bitewing radiographs can be crucial to identify interproximal caries in particular, which can often be missed on clinical examination. Therefore, radiographs form an integral part of a comprehensive oral health assessment to help determine risk, deliver the appropriate prevention, management of caries and provide better quality of patient care. Defence societies themselves advocate the importance of complete dental records and encourage correct prevention, diagnoses and treatment in line with current guidelines. The FGDP recommends radiographic audit, using guidelines as useful aids or to implement, ensuring the provision high quality of care.
The aim of the audit was to explore whether paediatric clinical examinations include radiographic assessments and whether radiographic assessments were retaken (at a suitable interval). A sample of 30 examination notes were randomly selected and screened for the presence of bitewings on children aged 6 to 16 years. After discussing and making improvements a second audit cycle (re-audit) was completed on another 30 paediatric patients.
The findings of the prospective audit have indicated that the guidelines for radiographic assessment and review in paediatric patients are not always followed by dental practitioners. However, the auditor acknowledges that patient cooperation can be especially worse in (younger) children which can in part explain poorer compliance in taking intraoral radiographs. Furthermore, there is limit with the audit time window for clinicians to implement change. The purpose of this audit was to improve on compliance to these best practice guidelines and in only a 3 month window there has been significant improvement. The compliance in taking radiographs has increased to 70% and the age at which patients have had their first bitewings taken decreased to 11 years old. All dental practitioners demonstrated a more positive attitude, motivation and capability to change since discussing the results of the first and second audit cycle. In conclusion therefore, this audit is encouraging to further better outcomes to the diagnoses, prevention and treatment of dental caries in children and improvement in the quality of care in the practice.
