Abstract
Design Questionnaire survey of 54 oral–maxillofacial surgeons and hospital-based dentists based in the USA, Europe and Australia. Results analysed using multiple regression.
Results The response rate was 81% (44 responses). Only nine clinicians (20%) reported using printed clinical guidelines for preradiation dental screening. As cues for extraction decisions, dental conditions had a relative importance of 62%, radiation dose 10% and tooth functionality 6%. Certainty about whether their decision was appropriate was significantly influenced only by radiation dose. Some respondents reported that their decision-making was largely influenced by patients' previous dental performance and by socio-economic considerations, which were not included in the questionnaire. Correlation between the clinicians' policies and the model for dental decision support (MDDS) was high (r=0.85).
Conclusions Clinicians' decision-making in this field appears to be based primarily on clinical experience and opinions rather than evidence-based clinical guidelines. These results need to be taken into consideration for further validation of the MDDS.
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References
Bruins HH, Koole R, Jolly DE . Pretherapy dental decisions in patients with head and neck cancer. A proposed model for dental decision support. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998; 86:256–267.
Cramer CK, Epstein JB, Sheps SB, Schechter MT, Busser JR . Modified Delphi survey for decision analysis for prophylaxis of post-radiation osteonecrosis. Oral Oncol 2002; 38:574–583.
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Address for correspondence: HH Bruins, Department of Oral and Maxillofacial Surgery, University Medical Centre Utrecht, University of Utrecht, Utrecht, The Netherlands.
Bruins HH, Jolly DE, Koole R. Preradiation dental extraction decisions in patients with head and neck cancer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 88:406–412.
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Kerr, A. Decision-making for preradiation dental extractions is based primarily on experience and opinion. Evid Based Dent 4, 11 (2003). https://doi.org/10.1038/sj.ebd.6400157
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DOI: https://doi.org/10.1038/sj.ebd.6400157
