Key Points
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This study reports the views of GDPs and specialist paediatric dentists on how they would approach the care of young children presenting with a range of common clinical scenarios.
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Large variation was found in the treatment choices for the scenarios within both generalists and specialists.
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Different patterns in the approach to care were found when generalists and specialists were compared.
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This variation is at odds with an evidence based approach to healthcare.
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Randomised controlled trials are needed to identify the best way of treating young children with carious primary teeth.
Abstract
Aim To measure the distribution of choices for the treatment of a child with differing severities of caries in a primary molar tooth among specialists in paediatric dentistry and general dental practitioners (GDPs) in England.
Method Two surveys were undertaken using the same tool. The populations invited to take part in the study were confined to dentists practising in England in 2004. They were 500 GDPs selected at random from the list of all GDPs with a National Health Service (NHS) contract identified by the Dental Practice Board (DPB) and all 148 specialists in paediatric dentistry appearing on the General Dental Council specialist register. The selected dentists were sent a questionnaire containing four hypothetical clinical case scenarios in which the severity of dental caries in a single primary molar differed. Each clinical case scenario had a list of possible treatment options and participants were asked to select their single most preferred treatment option. To maximise the response rate there were three mailing rounds.
Results Of the 500 GDPs and 148 paediatric specialists sent a questionnaire, 322 (64%) GDPs and 115 (78%) specialists responded. The answers to each of the case scenarios indicate differences of opinion both between and among GDPs and specialists in the care they would recommend for a child with caries in a primary molar tooth. This variation in opinion about care was more pronounced for a single deep carious lesion than for a less severe lesion. The spread of treatment options chosen in each scenario indicates disagreement among GDPs and specialists about restorative techniques and philosophy of care.
Conclusion In England there is wide variation among GDPs and specialists in paediatric dentistry about the best way to treat a young child with caries in a primary molar tooth. Well designed studies are urgently needed to provide strong evidence for the most effective way to manage the dental care of children.
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Acknowledgements
This study was funded by the Wellcome Trust, grant code GD535 EDCX. The views expressed in the paper are solely those of the authors.
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Tickle, M., Threlfall, A., Pilkington, L. et al. Approaches taken to the treatment of young children with carious primary teeth: a national cross-sectional survey of general dental practitioners and paediatric specialists in England. Br Dent J 203, E4 (2007). https://doi.org/10.1038/bdj.2007.570
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DOI: https://doi.org/10.1038/bdj.2007.570
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