Are patients referred for NHS-funded dental implant treatment being selected in accordance with national guidelines and subsequently funded by their primary care trust?

Introduction: The Faculty of Dental Surgery, The Royal College of Surgeons of England (RCSE), published a national guideline document in 1997 detailing specific selection criteria for National Health Service (NHS) funded dental implant treatment. The aim of this audit was to assess whether patients selected for NHS-funded dental implants at Bristol Dental Hospital (BDH) met the RCSE national criteria for treatment and received funding from their primary care trust (PCT).

Patients And Methods: A retrospective audit over a period of 2 years was undertaken using medical records and an existing Microsoft Excel database. All patients who had an application submitted to their local PCT for NHS-funded dental implants by BDH were included in this audit.

Results: A total of 82 applications for dental implant funding were made by BDH and 100% met the RCSE criteria. Fifty-one patients (62.2%) in total had their application for funding approved. Thirty-one patients (37.8%) that met the RCSE guidelines for NHS-funded dental implant treatment had their applications refused. Twenty-five (49%) out of 51 cases in the partially dentate category and six (27.3%) cases in the edentulous group were unsuccessful in their application for NHS-funded dental implants. However, all applications for patients with acquired maxillofacial defects were successful.

Conclusions: Patient selection by the BDH for NHS-funded implants complied with the RCSE guidelines. However, there was significant variation in funding between PCTs for those patients who apparently fulfilled the RCSE guidelines. NHS resources are not being allocated equitably for dental implant 'high-priority' patients and it would appear that a so-called 'postcode lottery' exists between PCTs.