Behavioural intervention to promote the uptake of planned care in urgent dental care attenders: a feasibility randomised controlled trial
Open accessPreprint — published as 10.1186/s12903-024-03942-2
Abstract
Background Urgent dental care may be the only place where many people, especially vulnerable groups, access care. This presents an opportunity for delivery of a behavioural intervention promoting planned dental visiting, which may help address one of the factors contributing to a socio-economic gradient in oral health. Although we know that cueing events such as having a cancer diagnosis may create a ‘teachable moment’ stimulating positive changes in health behaviour, we do not know whether delivering an opportunistic intervention in urgent dental care is feasible and acceptable to patients. Methods The feasibility study aimed to recruit 60 patients in a Dental Hospital and dental practices delivering urgent care within and outside working hours. Follow-up was by telephone, e mail and post over 4 months. Results Although the recruitment window was shortened because of COVID-19, of 47 patients assessed for eligibility, 28 were enrolled (70.1% of screened patients provided consent). A relatively high proportion were from disadvantaged backgrounds (46.4%, 13/28 receiving State benefits). Retention was 82.1% (23/28), which was also the rate of completion of the Oral Health Impact Profile co-primary outcome. The other primary outcome involved linking participant details at recruitment, with centrally-held data on services provided, with 84.6% (22/26) records partly or fully successfully matched. All intervention participants received at least some of the intervention, although we identified aspects of dental nurse training which would improve intervention fidelity. Conclusions Despite recruitment being impacted by the pandemic, when the majority of clinical trials experienced reduced rates of recruitment, we found a high recruitment and consenting rate, even though patients were approached opportunistically to be enrolled in the trial and potentially receive an intervention. Retention rates were also high even though a relatively high proportion had a low socio-economic background. Therefore, even though patients may be in pain, and have not anticipated involvement before their urgent care visit, the study indicated that this was a feasible and acceptable setting in which to position an opportunistic intervention. This has the potential to harness the potential of the ‘teachable moment’ in people’s lives, and provide support to help address health inequalities. Trial registration: ISRCTN 10853330 07/10/2019
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The RETURN trial was a pragmatic, multi-centre, randomised controlled trial conducted across 13 NHS dental practices and a Dental Hospital, all providing urgent NHS dental care in North-West England.
“The RETURN trial was a pragmatic, multi- centre, randomised controlled trial (RCT) conducted across 13 National Health Service (NHS) dental practices and a Dental Hospital, all providing urgent NHS dental care in North- West England [10].”
From Economic Evaluation of the <scp>RETURN</scp> Intervention to Increase Routine Dental Attendance Among Disadvantaged Adults: Net Health Benefit ( <scp>QALYs</scp> ) and Patient Cost Outcomes From a Randomised Controlled Trial (2026) · cites this paper as [10]
The Trial design section describes a randomised, two-arm study, and the Study settings passage places recruitment at urgent dental-care sites in North-West England, including a teaching dental hospital and NHS dental practice. The paper describes this as a feasibility study; our copy does not support the claimed count of 13 NHS dental practices or explicitly describe the trial as pragmatic. (LLM, conf=0.87)
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Self-citationRETURN Randomized Controlled Trial to Increase Adult Routine Dental Visits
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Lowers, V., Stanley, M., Hennessy, J., Morgan, E., Horsley, R., Vithlani, J., & Harris, R. V. (2026) · Research involvement and engagement · doi:10.1186/s40900-026-00857-w
Self-citation
- Authors
- Harris, R., Lowers, V., Best, A., Burnside, G., Clarkson, J., & Hulme, C.
- Affiliations
- University of Liverpool (GB)
- University of Dundee
- University of Exeter (GB)
- Corresponding author
- Harris, Rebecca
- Venue
- BMC Oral Health
- Published
- 2023-04-03
- Volume
- 24
- Issue
- 1
- Pages
- 195-195
- ISSN
- 1472-6831 (ISSN-L)
- PMC
- PMC10848507
- OpenAlex
- W4391564006
- Cited by
- 6
- References
- 27
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2
- FWCI
- 2.76
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Oral Health (publishedVersion, cc-by)
- Research Square (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- Discovery Research Portal (University of Dundee) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Research Explorer (The University of Manchester) (submittedVersion)
- Funders
- National Institute for Health and Care Research (RP-PG-0616-20004)
- Programme Grants for Applied Research (RP‐PG‐0616‐20004)
- Topics
- Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
- Health Sciences › Health Professions › General Health Professions › Dental Education, Practice, Research
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Keywords
- emergency dental care, behavioral interventions, teachable moments, health disparities, intervention fidelity, recruitment and retention, disadvantaged patients, Oral Health Impact Profile
- MeSH terms
- COVID-19, Ambulatory Care, Dental Care, Feasibility Studies, Humans, Surveys and Questionnaires
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