The development of a consensus among primary care dentists of referral criteria for school dental screening

Key Points It is possible for primary care dentists to agree referral criteria following school dental screening. This study reinforces earlier research which suggests that caries in the primary dentition is not perceived as an important trigger for referral following school dental screening. Standardisation of the referral criteria used in school dental screening is likely to enhance the quality of this dental public health activity. School dental screening is not seen by the profession as a vehicle to increase dental registration. Objective To obtain consensus amongst a sample of primary care dentists in the North West of England on a set of clinical criteria that should trigger referral following school dental screening. Design Delphi process. Setting Primary dental care, England 2002 Method Primary care dentists in the North West of England were randomly selected to complete a two round 'Delphi exercise' that included 10 potential referral criteria. The dentists were invited to express their level of support for the inclusion of each referral criterion. Main outcome measures Level of agreement for each referral criterion. Acceptance of any criterion was that the interquartile range should be no more than 3 scale points with the lower value being no less than 7. Results Eighty-eight dentists, (72.7%), completed the Delphi exercise. Six referral criteria met with the groups' approval: Child with caries in permanent dentition Child with darkened/discoloured permanent incisors Child aged 9-10 years with overjet greater than 10 mm Child over six years with either gross plaque, calculus or swollen gums Child with evidence of sepsis Child registered with a GDP with caries in permanent dentition . Conclusion It is possible for a representative sample of primary care dentists in the North West to agree referral criteria following school dental screening.