Routine six-month checkups don’t improve the oral health of low-risk adults, according to a study by the University of Manchester, University of Dundee, and Cochrane Oral Health that investigated the optimal intervals between dental visits.
Dentists typically recommend that their patients have checkups twice a year, even though the risk of developing dental disease is different for each individual, the researchers said.
However, England’s National Institute for Health and Care Excellence has recommended personalized risk-based recall intervals between checkups based on each individual’s risk of developing dental disease since 2004.
The researchers said they looked at the most current and robust evidence available including two randomized controlled trials involving 1,736 patients that examined how different intervals between checkups affected how many people had tooth decay, how many tooth surfaces were affected by decay, gum disease, and well-being.
“The review shows that current practice of scheduling six-monthly checkup appointments for all patients does not improve oral health compared to a personalized risk-based checkup approach of compared to checkups every two years where patients are at low risk of dental disease,” said Patrick Fee, BDS, clinical research fellow at the University of Dundee School of Dentistry and review lead.
“The absence of any difference between checkup frequency indicates a risk-based checkup frequency can be supported, as it is not detrimental to oral health and is acceptable to patients. But it should be emphasized this is about adults having routine checkups, not those who seek emergency treatment for children,” said Fee.
“Current practice of six-monthly checkups could be considered an inefficient use of [National Health Service] resources, adding unnecessary patient and health service costs for no gain in dental health outcomes,” said Fee.
“This research is also valuable when considering the significant impact of the COVID-19 global pandemic and its effect on dental services worldwide, limiting patient access to dental treatment,” said Fee.
“Patient access to dental care may remain limited for some time. However, the results of this review provide reassurance to those providing and seeking dental treatment that intervals between checkups can be extended beyond six months without detriment to the oral health of patients,” Fee said.
“Six-monthly checkups are highly valued by the general population and moving towards personalized risk-based checkups will require the cooperation of healthcare policymakers, clinician knowledge, and patient involvement,” he said.
One of the clinical trials that the review looked at, the INTERVAL Dental Recalls Trial, was sponsored by the University of Dundee and conducted to add to existing evidence to help answer the research question.
The researchers concluded that in adults, there was little to no difference between six-monthly and risk-based checkups for number of tooth surfaces with decay, gum disease, and well-being after four years and probably little to no difference in how many people had moderate to extensive tooth decay.
Also, the researchers found moderate to high evidence that there is little to no difference between either yearly, twice yearly, or risk-based checkups in the number of tooth surfaces with decay, gum disease, and well-being.
The study, “Recall Intervals for Oral Health in Primary Care Patients,” was published by Cochrane Database of Systematic Reviews.
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