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Scottish Prisons' Dental Health Survey 2002
Appendix 4 Clinical Criteria for dental examination
Dentist's instructions on how to handle professional questions in the dental examination
In most circumstances the dental examiners do not make any comment about what they see during the examination. If the participant asks about their dental treatment need, or if questions related to the standard of previous dental care arise, the response will be that the survey is not designed to collect the sort of information on which a treatment can be planned, and that visiting a dentist is the best way of ensuring a thorough dental check-up. This is not only a way of deflecting potentially difficult questions, it is also absolutely true.
However, the interviewer is permitted to say, when recruiting participants, that as a dentist, you may be able to offer them some advice on the best way of looking after their mouth or teeth. If after the examination the subject wishes to know about their mouth you can give an indication of whether there is room for improvement in terms of the general oral hygiene/cleanliness and/or a general statement along the lines of:
"The best way of getting information about any treatment you might need is by seeking advice from a dentist".
The Prison Medical Service can advise the prisoner on how to get an appointment.
If you are asked to comment on specific aspects of oral hygiene, we would suggest that you respond, if appropriate, by identifying areas for improvement but say that they will need more specific advice from a dentist or a dental hygienist since there are many ways of achieving this. It is very important that you are not too prescriptive and that you adhere to general principles as there should be no scope for oral hygiene advice being given which conflicts with previous hygiene advice. You should preface this by saying:
"What I generally tell people is.........".
If you are asked to comment on specific aspects of past treatment, you need to say:
"This survey is limited and you need to see a dentist for specific advice and/or treatment".
The only exception to this protocol is if the examining dentist notices a lesion that he/she considers may be serious and potentially life threatening (such as suspected malignancy). Examiners are very unlikely to encounter such potentially serious pathology; the incidence of these lesions is very low. The examination is not a screening exercise and does not involve examination of the oral soft tissues. However, it is possible that such a lesion may be noticed and, as the implications are serious, a protocol to deal with this eventuality is in place.
Signed consents required
The following signed consents need to be sought:
For every respondent - to carry out the oral examination and in very rare circumstances, to inform the Prison Medical Officer of any serious oral pathology. You are unlikely to encounter this.
Returning the signed consent forms
For each person recruited to the survey you must complete and return a consent form for the examination.
Age of consent
Young people aged 16-17 years - can give signed consent for themselves. Anyone younger than 16 years of age will not be examined.
Please ensure that the necessary signatures are given in the correct places on the form. We recommend that you indicate, with a cross, the places where signatures are required - and whose signature is required at the place.
Please check that all signatures on all consent forms are dated at the time they are signed.
Interviewer - procedures for oral health examination
The oral health examination will take less than five minutes; it will not involve any treatment to the teeth and nor will any x-rays be taken. It will be carried out in the prison by a trained dental examiner and you will act as a 'recorder'; recording the condition of various teeth and tooth surfaces as they are examined. This recording will be done onto a lap-top computer.
The only adults who will
not be asked to participate in an examination will be those
with no natural teeth.
You need:
You
must obtain signed consent from the respondent before starting a dental examination.
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