Decision making in endodontics among the endodontic profession and general practitioners in Norway

Abstract

ABSTRACT

Background: Considerable variation between and within groups of NEF members and general practitioners (GPs) has been shown in the choice of endodontic retreatment options. However, uniform criteria and consensus in decision-making would be of importance when the clinical training in the dental school is arranged in a community setting by GPs employed as clinical instructors. Objectives: To assess the level of consensus in decision making in endodontic re-treatment among members of the Norwegian Endodontic Society (NEF) and a group of GPs employed at the extern clinics associated with the Institute of Clinical Dentistry at the University of Tromsø, Norway. Methods: All 65 practicing NEF members with valid e-mail addresses and all 39 GPs employed at the 10 extern clinics were addressed. A questionnaire with 26 radiographs from potential endodontic re-treatment cases and a fabricated patient history common to all of them was sent online by Questback internet program. Six treatment options were given, four of them suggesting active treatment. The results were analysed with SPSS (17.0) and Likelihood Ratio was calculated to show the differences between the groups. Results: 42 NEF members (65%) and 26 GPs (66%) responded. Half of the cases showed statistical significant differences (p<0.05) between the groups in the choice of treatment. There was no consensus among either of the groups in any case, but the NEF members showed relative consensus between active and non-active treatment in three cases. The NEF members favoured active treatment in cases where the majority of GPs would have waited another 12 months. Conclusions: The results show lack of consensus in the clinical decision-making in both groups, thus reflecting the need for continuing education in the key literature behind the rationale of various treatment options.