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Case mix

Case mix is a tool developed by the BDA to help dentists gauge the complexity of patients according to six identifiable criteria. The results of this can be used in both commissioning/contract matters and also wider epidemiological work.

In Spring 2019 the BDA launched an updated version of its case mix tool; 'case mix 2019'. The tool has been revised to include;


  • Criteria for paediatric patients
  • More thematic measures of complexity.

The tool retains its six core measures of;


  • Ability to communicate
  • Ability to co-operate
  • Medical status
  • Oral risk factors
  • Access to oral care
  • Legal and ethical barriers to care

and offers users the ability to score across four separate ranges.

Following calls from commissioners to use the tool to measure paediatric dental patient complexities the tool has received a root and branch update, with new criteria geared around the needs of young patients, following input from the British Society of Disability and Oral Health and British Society of Paediatric Dentistry. Definitions already included for adult patients have also been revised.

Discussions with IT suppliers are already ongoing and the BDA will be producing training on the new tool later in 2019.

It remains the most appropriate way of measuring the complexity of patients and is recognised in commissioning decisions and is also used for epidemiological purposes.

The tool is now available to download. We will provide online training for the tool later in 2019.

​For further information, please contact Stephen Skelton.