RETURN Main Trial
Research type
Research Study
Full title
InteRvention to rEduce inequaliTies in the Uptake of Routine deNtal care - Main trial
IRAS ID
288546
Contact name
Rebecca V. Harris
Contact email
Sponsor organisation
University of Liverpool
ISRCTN Number
ISRCTN84666712
Duration of Study in the UK
3 years, 5 months, 31 days
Research summary
People living in deprived areas often put off visiting a dentist until they have a problem. But leaving it this late often means that decay is too far gone to save the tooth, meaning extraction is necessary. This affects peoples’ dental health for the rest of their lives and can leave them embarrassed about their appearance (avoiding smiling etc.). Since over half of people with urgent dental problems receive antibiotics, leaving dental visits until there is pain and infection, this adds to the problem of antibiotics being less effective against bacteria because they are used so widely.
By exploring barriers to dental visiting with both patients using urgent dental care services, and local members of the community, the RETURN programme (WP1, REC ref: 18/NE/0061) has developed the RETURN intervention to try and help patients to plan and keep appointments for dental check-ups and regular care.
The RETURN intervention includes booklets and 1-3 minute video clips about common barriers to visiting the dentist, providing information and persuasive messages designed to help patients take up planned dental care. The video clips are of a person talking to the camera about their experience about that barrier to care (put off by the cost of treatment), which is overlaid with an animation. A dental nurse will be trained to talk to the patients about the barriers they experience, and the patient will watch one of the clips while attending for their urgent dental appointment (others will be able to be viewed online by the patient afterwards. The nurse will also help the patient to set an action plan of things they plan to think about and do to help the patient attend for planned dental care. The patient will be given the intervention pack and resources to take home. The intervention pack will also contain other resources such as a credit card sized card that can be given to the patient’s employer showing they need time off to attend a dental appointment, and relaxation exercises to use in the waiting room for anxious patients. Intervention patients will also receive a follow-up text a few days later to thank them for taking part, and to remind them about the plan they set out. The delivery of the RETURN intervention has been previously tested in a feasibility study.
The RETURN trial (the current study) will recruit 1180 urgent dental care users to a randomised controlled trial across three types of urgent dental care setting: a Dental Hospital, in-hours urgent care dental practice and out-of-hours urgent care dental practice, over a period of 12 months. Patients will consent to take part in the trial at their urgent care appointment, and be randomised to either to control or intervention group. Intervention group patients will receive the intervention, facilitated by a trained dental nurse. The control group just get usual care (any information from the dental team at the end of their urgent dental care appointment that is usually given), although like the intervention group, they will watch a 2 minute video clip with animation, thanking them for taking part in the study and letting them know about the follow-up contacts and payment for their time in taking part in the study.
Patients will then be followed up by making phone calls at 6, 12 and 18 months to see if they have been for dental check-up(s) or treatment. For people not contacted by phone, contact by e mail and post will be tried. This trial aims to assess the effectiveness and cost-effectiveness of the RETURN intervention and to explore whether the intervention has different effects across the socio-economic gradient.
REC name
London - Camberwell St Giles Research Ethics Committee
REC reference
21/LO/0059
Date of REC Opinion
10 Mar 2021
REC opinion
Further Information Favourable Opinion