How dentists diagnose and treat defective restorations: evidence from the dental practice-based research network

TY - JOUR

T1 - How dentists diagnose and treat defective restorations: evidence from the dental practice-based research network

AU - Gordan, Valeria V

AU - Garvan, Cynthia W

AU - Richman, Joshua S

AU - Fellows, Jeffrey L

AU - Rindal, D Brad

AU - Qvist, Vibeke

AU - Heft, Marc W

AU - Williams, O Dale

AU - Gilbert, Gregg H

AU - DPBRN Collaborative Group

N1 - Keywords: Dental Caries; Dental Restoration Failure; Dental Restoration, Permanent; Dentist's Practice Patterns; Female; Humans; Male; Practice Management, Dental; Questionnaires; Retreatment

PY - 2009

Y1 - 2009

N2 - OBJECTIVES: To (1) identify and quantify the types of treatment that dentists use to manage defective dental restorations and (2) identify characteristics that are associated with these dentists' decisions to replace existing restorations. The Dental Practice-Based Research Network (DPBRN) consists of dentists in outpatient practices from five regions: AL/MS: Alabama/Mississippi; FL/GA: Florida/Georgia; MN: dentists employed by HealthPartners and private practitioners in Minnesota; PDA: Permanente Dental Associates in cooperation with Kaiser Permanente's Center for Health Research and SK: Denmark, Norway and Sweden. METHODS: A questionnaire was sent to all DPBRN practitioner-investigators who reported doing some restorative dentistry (n = 901). Questions included clinical case scenarios that used text and clinical photographs of defective restorations. Dentists were asked what type of treatment, if any, they would use in each scenario. Treatment options ranged from no treatment to full replacement of the restoration with or without different preventive treatment options. The authors of the current study used logistic regression to analyze associations between the decision to intervene surgically (repair or replace) and the specific dentist, practice and patient characteristics. RESULTS: A total of 65% of dentists would replace a composite restoration when the defective margin was located on dentin and 49% would repair it when the defective margin was located on enamel. Most (52%) dentists would not intervene surgically when the restoration in the scenario was amalgam. Dentists participating in a solo or small private practice (SPP) chose surgical intervention more often than dentists participating in large group practices (LGP) or in public health practices (PHP) (p < .0001). Dentists who do not routinely assess caries risk during treatment planning were more likely to intervene surgically and less likely to choose prevention treatment (p < .05). Dentists from the SK region chose the "no treatment" option more often than dentists in the other regions. CONCLUSIONS: Dentists were more likely to intervene surgically when the restoration was an existing composite, compared to an amalgam restoration. Treatment options chosen by dentists varied significantly by specific clinical case scenario, whether the dentist routinely performs caries risk assessment, type of practice and DPBRN region.

AB - OBJECTIVES: To (1) identify and quantify the types of treatment that dentists use to manage defective dental restorations and (2) identify characteristics that are associated with these dentists' decisions to replace existing restorations. The Dental Practice-Based Research Network (DPBRN) consists of dentists in outpatient practices from five regions: AL/MS: Alabama/Mississippi; FL/GA: Florida/Georgia; MN: dentists employed by HealthPartners and private practitioners in Minnesota; PDA: Permanente Dental Associates in cooperation with Kaiser Permanente's Center for Health Research and SK: Denmark, Norway and Sweden. METHODS: A questionnaire was sent to all DPBRN practitioner-investigators who reported doing some restorative dentistry (n = 901). Questions included clinical case scenarios that used text and clinical photographs of defective restorations. Dentists were asked what type of treatment, if any, they would use in each scenario. Treatment options ranged from no treatment to full replacement of the restoration with or without different preventive treatment options. The authors of the current study used logistic regression to analyze associations between the decision to intervene surgically (repair or replace) and the specific dentist, practice and patient characteristics. RESULTS: A total of 65% of dentists would replace a composite restoration when the defective margin was located on dentin and 49% would repair it when the defective margin was located on enamel. Most (52%) dentists would not intervene surgically when the restoration in the scenario was amalgam. Dentists participating in a solo or small private practice (SPP) chose surgical intervention more often than dentists participating in large group practices (LGP) or in public health practices (PHP) (p < .0001). Dentists who do not routinely assess caries risk during treatment planning were more likely to intervene surgically and less likely to choose prevention treatment (p < .05). Dentists from the SK region chose the "no treatment" option more often than dentists in the other regions. CONCLUSIONS: Dentists were more likely to intervene surgically when the restoration was an existing composite, compared to an amalgam restoration. Treatment options chosen by dentists varied significantly by specific clinical case scenario, whether the dentist routinely performs caries risk assessment, type of practice and DPBRN region.

M3 - Journal article

C2 - 19953775

SN - 0361-7734

VL - 34

SP - 664

EP - 673

JO - Operative Dentistry

JF - Operative Dentistry

IS - 6

ER -