This is a change to the way that NHS primary care dentistry has previously been provided by most high street practices. It may need a different mindset and way of working.
Implementing the care pathway
The care pathway starts with an oral health assessment (OHA). The assessment takes account of the patient’s oral health and medical history.
Patients are scored using a RAG (red, amber, green) system to indicate their risk of disease. The score is used to create a treatment plan, which will include:
- prevention and self-care advice
- the amount of time until their next review
Our evidence and learning through the programme has indicated that patients have improved oral health if:
- the importance of self-care to limit the disease process is fully explained
- they are encouraged to actively look after their teeth and gums
To successfully implement the pathway, there must be:
- an appreciation of the various components underlying this approach
- an understanding of how these fit together
You can view clinical guidance on implementing the care pathway:
Medical and social history forms
Patients are asked to fill in questionnaires to determine their RAG score.
The RAG score is generated based on answers given to specific questions about their medical history and lifestyle.
These questions are in the template questionnaires which have been designed to support the care pathway:
Practices can adapt the templates to include questions the clinicians want to ask. Revised templates must include the mandatory questions that are used to generate the RAG score.
Medical history mandatory questions include whether there has been a history of:
- eating disorders
- gastro-oesophageal or acid reflux
Social history mandatory questions include:
- use of fluoride toothpaste
- diet risk factors such as carbonated drinks or sugary snacks
- sibling carries risk (children)
- smoking and alcohol consumption
There are several ways practices can work differently to make sure they maintain or improve access to services. These include:
- introducing more skill mix within the team
- improving communications with patients
Practices can change their working patterns to provide flexible appointments.
This can be achieved by implementing shift working arrangements.
Regularly reviewing how your practice is working can help to work out what changes to make and when. This means patients can continue to access services within a reasonable timeframe.
Prototype treatment codes
View the list of prototype treatment codes (PDF: 464KB). This is used to map treatments given by your practice to the codes used by the prototype system.
Old codes have been struck out, but are left visible to show the change history of the document.