Until recently, and since the inception of the National Health Service in 1948, general dental practitioners [GDPs] have worked in a stable environment. In recent years these GDPs have experienced dramatic changes in the way that primary oral health care is delivered to the public. This research aims to understand the strategic planning processes and the issues that are involved within the management of these changes that are currently occurring in general dental practice. The research question asks "What model could General Dental Practitioners use in their strategic approach to managing the enforced changes that are occurring within primary Dental Care". This thesis adopts the approach that all GDPs work within a “Small business” environment but that they are constrained by “professional” requirements. The changes now mean that these GDPs need to become proactive in their decision-making processes. The present system of primary oral health care within the U.K. is designed for the treatment and repair of damage caused by dental disease; it has not been prevention orientated. Changes such as disease processes, the financing of the NHS, demographic changes all mean that GDPs will require, in some degree at least, to re-evaluate their personal objectives and strategies. Historically, GDPs might be considered to have been reactive in their approach to these gradual changes. The ‘item of service’ payment system used within the NHS to remunerate GDPs is unique and therefore no existing small business model satisfies the requirements of GDPs. The research involved a population of 449 West Midland GDPs. The findings of the research indicated that certain core issues were significant in how dentists decided to operate their clinical practice. Significant gaps were revealed in the current literature and the research findings were used to develop a totally new decision making model. This model attempts to embrace the current changing scenario and by using this model, GDPs can evaluate their individual position within this changing framework of general dental practice and thus be better informed in their decision making processes. The need for further research is explained and suggestions are made for other areas that might be considered of importance to dentists and the delivery of primary oral health care.

In order to obtain perspectives of Canadian dentists on the quality of the undergraduate education received in orthodontics and the extent of orthodontic services provided, a descriptive survey was constructed. Methods An anonymous, web-based survey was created using Survey Monkey® (Palo Alto, USA), and distributed to registered dentists in Canada via links in newsletters and mass emails. Results There were 427 respondents. Results showed that 71% of dentists provide some orthodontic treatment, and 33% of them offered only space maintainers. A total of 23% treated most of their patients requiring interceptive treatment, compared to 15% for those requiring comprehensive treatment. A driving time greater than 1 hour to the closest orthodontist resulted in a 16% increase in the provision of orthodontic treatment by the general dentists. The undergraduate orthodontic education was deemed above average by 21.4% to 50.5% of the respondents. Conclusions The percentage of dentists currently providing orthodontic services to their patients is similar to previous reports. A driving time of more than 1 hour is an influencing factor on the provision of orthodontic treatment by Canadian general dentists. The quality of undergraduate orthodontic education provided has improved over the last 25 years, although some amelioration may be beneficial.

Magister Chirurgiae Dentium (MChD) / Exodontia remains one of the most regularly done procedures in dentistry in South Africa (SA) and alveolar osteitis (AO) is considered one of the most common complications associated with exodontia. Despite the extensive research done on this clinical entity, the management of AO still remains controversial. Various management protocols have been suggested in the literature, varying from prophylactic to symptomatic management of AO (Blum,2002). However, none of these management protocols have to date shown any conclusive evidence on the effectiveness and benefit over another protocol. The author was of the opinion that general dental practitioners (GDPs) in South Africa generally use preventative and treatment protocols based on what they were taught at their alumni dental schools or use protocols modified from their own clinical experience in practice. The aim of this study was to assess which treatment protocols are routinely used by GDPs in South Africa for the management of AO and suggest a scientifically sound treatment protocol for AO. The study was done in the form of a questionnaire and the participants were randomly selected from the Health Professions Council's register. The results showed that most of the GDPs in South Africa continued to use the same treatment protocol as their alumni dental school. They were of the opinion that these protocols were still clinically the most effective. Despite the plethora of intra-alveolar medicaments available, Alvogyl®still remains the medicament of choice of GDPs. As there is no evidence in the scientific literature that suggests that one intra-alveolar medicament or antibiotic is more effective than the other, the author does not encourage the use of the medicaments or antibiotics in the treatment of AO. However, by following simple measures such as improving patients' oral hygiene and using a pre-operative 0.2% chlorhexidine mouth rinse, the incidence of AO can be reduced significantly.