Minimum intervention oral care - incentivising preventive management of high-needs/high caries-risk patients using phased courses of treatment

• Published in: British dental journal 2024-03, Vol.236 (5), p.379-382
• Main Authors: Banerjee, Avijit, Hameed, Zain, Chohan, M. Ali, Patel, Kish, Vaghela, Jin J., Sheikh, Fahad, Barker, Nick, Shah, Pritesh, Patel, Divyash
• Format: Article
• Language: English
• Subjects: Clinical; Delivery of Health Care; Dental care; Dental caries; Dental Caries - prevention & control; Dental Caries Susceptibility; Dentistry; Humans; Motivation; Oral Health; Oral hygiene; Patients; Prevention; Primary care; Risk Assessment; Susceptibility
• ISSN: 0007-0610; 1476-5373
• DOI: 10.1038/s41415-024-7132-2

This paper demonstrates how person-focused, prevention-based, risk/needs-related, team-delivered, minimum intervention oral care (MIOC) principles and approaches can be integrated into the dental profession for the delivery of environmentally sustainable, optimal care to high-needs and high caries-risk/susceptibility patients. It highlights the potential for NHS remuneration for prevention-based, phased, personalised care pathways/plans (PCPs) within a reformed NHS dental contract system. It emphasises the importance of comprehensive and longitudinal patient risk/susceptibility assessments, prevention and stabilisation of the oral environment before considering more complex, definitive restorative work. This paper forms the first of several components of a suite of educational/information materials needed to instil confidence and implementation protocols within primary care clinical oral health care teams delivering MIOC through phased PCPs, especially when managing patients with high needs and/or disease susceptibility. Key points The development of a team-delivered, prevention-based, person-focused, susceptibility/needs-related phased care approach to modern caries management using the minimum intervention oral care delivery framework in primary care is proposed. Using personalised care plans within phased courses of treatment, aligned to periodontal management guidelines, caries prevention in primary care can be incentivised. The potential for NHS remuneration for prevention-based, phased, personalised care pathways/plans (PCPs) within a reformed NHS dental contract system is outlined.