Randomised trial of education vs. remuneration for dentists


Clarkson, J., Pitto, M., Southwick, C., Sullivan, F. and Tilley, C. (University of Dundee) Scott, A. (HERU) Johnston, M., Grimshaw, J. and Ramsay, C. (HSRU, University of Aberdeen)


This study was a randomised controlled trial which evaluated the costs and benefits of different strategies to encourage dentists to apply fissure sealants to children’s teeth. Targeting dentists in relatively deprived areas, dentists were randomised to a control group, a group which is paid a fee, a group that receives education in evidence-based dentistry, and a group that receives both a fee and the educational intervention. The main outcome was the number of fissure sealants placed per dentist and the study also examined the costs of intervention. The primary outcome was 9.8% higher when a fee was offered. The education intervention had no statistically significant effect. ‘Fee only’ was the most cost-effective intervention.


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Clarkson, J.E., Turner, S., Grimshaw, J.M., Ramsay, C.R., Johnston, M., Scott, A., Bonetti, D., Tilley, C.J., Maclennan, G., Ibbetson, R., MacPherson, L.M.D. and Pitts, N.B. “Changing Clinicians’ Behaviour: a Randomized Controlled Trial of Fees and Education” Journal of Dental Research. 2008; 87(7): 640-644.

Clarkson, J., Bonetti, D., Maclennan, G., Ramsay, C., Scott, A., Tilley, C. and Turner, S. The effect of remuneration and education on the implementation of research evidence to reduce inequalities in oral health. Focus on Research, Chief Scientist Office, (CZP/3/2), 2006.