PhD Understanding referrals for dental general anaesthetics in children, an exploration of clinician behaviour

About the Project

This research aims to investigate the drivers behind high referrals for dental decay from General Dental Practitioners (GDPs) in paediatric dentistry. Specifically, cases where GDPs refer children whom the triagers, consultants or specialists in the area deem could be managed within primary care. There are several reasons associated with the decision to refer children out of primary care when a child has dental decay, including; the number of teeth that need to be extracted, acute pain experienced, the age of the child referred or the behaviour i.e. anxiety or needs of the child. Previous studies have also indicated that the majority of Dental General Anaesthetics (DGA) are primarily for caries, with two such studies showing this figure is as high as 94%. Previous studies have indicated that a high number of referrals can be inappropriate for GA extraction with poor correlation between service requested and treatment plans determined by the surgeon.

Using referral data, we will identify patterns in referral behaviour to understand the circumstances in which higher than average/anticipated referrals occur.

The study will assess the potential for behaviour change among GDPs where high/inappropriate referrals are established by evaluating whether targeted interventions—such as additional training, regular feedback, or system-level support—could reduce some of these referrals. Through qualitative and quantitative analysis, we aim to understand barriers to in-practice treatment and determine which behaviour change strategies could be most effective in promoting appropriate care within primary dental services.

The study could provide information for commissioners and stakeholders within the area to help reduce the high number of referrals out of primary care, reducing burden on secondary care.

Eligibility

Applicants are expected to hold (or about to obtain) a minimum upper second class undergraduate honours degree (or equivalent) in dentistry, psychology, social sciences, oral health sciences, public health, statistics or similar health-related degree. A Masters degree in a relevant subject and/or experience in dentistry, public health, dental public health, psychology, research methods is desirable.

How to Apply

For information on how to apply for this project, please visit the Faculty of Biology, Medicine and Health Doctoral Academy website https://www.bmh.manchester.ac.uk/study/research/apply/. Informal enquiries may be made directly to the primary supervisor.

For international students, we offer the opportunity for you to undertake an accredited teaching certificate whilst carrying out your research with our PhD with Integrated Teaching Certificate. We also offer self-funded international students the chance to study a master’s before progressing onto a PhD with our Integrated PhD. Visit our international postgraduate researchers page to find out more.

Funding Notes

Applications are invited from self-funded students. This project has a Band 2 fee. Details of our different fee bands can be found on our website View Website

References

Nic Iomhair A, Moore D, Hall-Scullin E, Bowes L, Seasman A. The Greater Manchester Child Friendly Dental Practice Scheme: Using a Transformational Commissioning Approach to Align Paediatric Dental Service Provision with Childhood Oral Health Needs in Greater Manchester. Community Dent Health. 2022 Nov 30;39(4):219-224. doi: 10.1922/CDH_00110NicIomhair06. PMID: 36196993.

Pretty IA, Goodwin M, Coulthard P, Bridgman CM, Gough L, Jenner T, Sharif MO. Estimating the need for dental sedation. 2. Using IOSN as a health needs assessment tool. Br Dent J. 2011 Sep 9;211(5):E11. doi: 10.1038/sj.bdj.2011.726. PMID: 21904335.