Treatment planning of damaged teeth: to recover or to extract?

Minerva Stomatol. 2017 Oct;66(5):201-211. doi: 10.23736/S0026-4970.17.04036-5. Epub 2017 Sep 22.

Abstract

Background: Planning the treatment of a compromised tooth is challenging but the choice should refer to evidence-based criteria. The literature proved that patient-related factors influence the treatment plan, but what happens when the patient is a dentist? Aim of the study was to observe whether the dentist goes for the same option suggested to a patient in a hypothetical scenario.

Methods: One hundred volunteers were interviewed singularly in a quiet ambient. Radiographs of 15 compromised teeth were shown and were identified as belonging to a hypothetical patient with non-contributory medical history asking for the best treatment. For each clinical case, the dentist could decide between: extraction (E), endorestorative recovery (R); referral to a specialist (S) to save the tooth. After a 15-minute wash-out, the same radiographs were shown again with the question: if this was your tooth, what would you do? The alternatives could be E or R. Statistical analysis was performed in order to evaluate the discordance between the choice taken for the patient and for the dentist's teeth.

Results: A constant increase in recovered teeth was observed in group D with the only exception of case 12. Concordance ranged from scarce to substantial, while symmetry showed that, when changing their mind, the dentists recovered their own teeth.

Conclusions: The dentists were more conservative on their teeth: this shows the absence of a coherent decision-making pattern and stresses the need for an improvement in the formation of dental practitioners.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Clinical Decision-Making*
  • Dental Caries / surgery
  • Dental Restoration Failure
  • Dental Restoration, Permanent / psychology*
  • Dentists / psychology*
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Radiography, Dental
  • Referral and Consultation
  • Root Canal Therapy
  • Tooth Extraction / psychology*
  • Young Adult