Cochrane concludes less gain from 6-month dental check-ups
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- Published: Sunday, 18 October 2020 17:47
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Cochrane Oral Health has carried out a systematic review to identify the best time interval to have between dental check‐ups. They concluded that in adults, there was little to no difference between six‐monthly and risk‐based check‐ups in tooth decay, gum disease and quality of life after four years; and probably little to no difference in how many people had moderate‐to‐extensive tooth decay.
Authors conclusions
“For adults receiving dental check‐ups in primary care settings, there is high‐certainty evidence that there is little to no difference in oral health outcomes (tooth surfaces with any caries, gingivitis and oral‐health‐related quality of life) when comparing 6‐month recall interval with a risk‐based recall interval. In addition, there is moderate‐ to high‐certainty evidence that there is little to no difference in oral health outcomes when comparing a 24‐month recall interval with either 6‐month or risk‐based intervals.
“When comparing risk‐based recall with 6‐month recall intervals, there is little to no difference in the number of tooth surfaces with any caries, percentage of sites with gingival bleeding and oral‐health‐related quality of life over a 4‐year period (high‐certainty evidence). There is probably little to no difference between the recall strategies in the prevalence of moderate to extensive caries over the same time period (moderate‐certainty evidence).
“When comparing 24‐month with either 6‐month or risk‐based recall intervals, there is moderate‐ to high‐certainty evidence that there is little to no difference in the number of tooth surfaces with any caries, percentage of sites with gingival bleeding and oral‐health‐related quality of life over a 4‐year period.
“The available evidence on recall intervals between dental check‐ups for children and adolescents is uncertain. The two trials included in the review did not assess adverse effects of different recall strategies.
“Further studies comparing dental recall intervals for adults in primary care seem unnecessary, given the moderate to high certainty of the evidence for the outcomes of this review. Given the uncertainty of the evidence from one study on recall intervals between dental check‐ups for children and adolescents, there is a need for well‐conducted randomised controlled trials in this area, including a sufficient number of participants to detect a true difference, if any; similar outcome measures to this review; and of adequate duration.”
Link
Fee PA, Riley P, Worthington HV, Clarkson JE, Boyers D, Beirne PV. Recall intervals for oral health in primary care patients. Cochrane Database of Systematic Reviews 2020, Issue 10. Art. No.: CD004346. DOI: 10.1002/14651858.CD004346.pub5.
Recall intervals a non-problem??
Dear All,I find this Cochrane review both very limited in scope and highly worrying at the same time.
No harm or risks have been shown by regular 'prevention' checks and given this should be individualised by the person who KNOWS the patient best (the examining Dentist) then why not state the DENTIST knows best, because frankly there is no good evidence that is credible in this arena, unless it spans across DECADES in its analysis.
I would also like to highlight that it is Oral Cancer Awareness month in November soon and only Dentists examine the whole mouth directly, regularly, for the majority of our population!!
Oral cancer now kills more people annually than cervical cancer and testicular cancers added together - gum diseases are at a serious BPE level 3 for 45% of the population and as we know, Dental Diseases/Infections are now being closely linked to Medical ill-health and complications too, from Heart Disease to Diabetes.
I could go on, but rationing recalls is dangerous!
Dentists can accurately assess patient risk of disease
There is a really positive message here that dentists are able to accurately assess patients’ risk of oral health problems and allocate appropriate risk-based recall intervals ranging from 3-24 months such that check-ups can be extended beyond six months without detriment to patient oral health after four years of follow-up.Evidence for risk-based dental recalls
As part of a dental check-up, examination of the soft tissues is important to identify any signs of oral cancer. We know that risk factors for oral cancer are similar to risk factors for dental decay and gum disease – patients who smoke, who drink alcohol and who are from lower socioeconomic status are at increased risk of gum disease and dental decay as well as oral cancer. So a risk-based recall would allow those at greater risk to be seen more frequently while healthy patients can be seen less frequently. We also know that in Scotland – where the incidence of oral cancer is highest in the UK – that the majority of patients diagnosed with oral cancer hadn’t actually attended a dental check-up at all in the 2 years preceding diagnosis. If these patients were on a risk-based recall they would likely be seen more often by their dentist than they are currently.Evidence for risk-based dental recalls
Dentists in Scotland, where oral cancer incidence is highest in the UK, will see a case of oral cancer once every 10-20 years. The UK National Screening Committee advises the health service about screening for all diseases and has considered oral cancer screening a number of times and previously rejected it for these reasons. It is however important for dentists to check the soft tissues at every check-up and for patients at high risk of dental disease and oral cancer to be seen more frequently than patients at low risk of these diseases.You need to be logged in to leave comments.
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