Factors influencing choice of dental treatment by private general practitioners.

Full Abstract

Service rate variations have focused attention on treatment decisions. The aims of this study were to examine factors considered in choosing treatments, to classify dentists in terms of clinical decision making, and to investigate the association of decision making with services provided. From a random sample of dentists (response rate 60.3%) treatment constraints (15.0%), periodontal status (12.1%), tooth status (11.3%), mouth status (10.1%), and patient factors (9.8%) were considered important factors across six alternative treatment pair choice scenarios. Cluster analysis of the treatment choice scenarios produced one cluster that reflected patient preferences, another that reflected treatment constraints such as cost, and a third that reflected oral health factors. Compared with the oral health cluster, dentists in the constraints cluster had higher rates (p < .05) of extractions (rate ratio [RR] = 1.49), bridge work (RR = 1.77), and dentures (RR = 1.32), whereas dentists in the patient cluster had higher restoration rates for two-surface ionomers (RR = 2.45) and resins on three or more surfaces (RR = 1.50) and other preventive services (RR = 1.78) such as oral hygiene instruction. Although a range of factors influenced treatment choice, a limited set accounted for the majority of responses, with cost a major determinant, ahead of oral health status and patient preference. Decision-making style was associated with service provision.

Author information

Author/s: Brennan, David S (DS); Spencer, A John (AJ);

Affiliation: Dental School, Faculty of Health Sciences, Adelaide University, South Australia 5005.

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: International journal of behavioral medicine (Int J Behav Med), published in United States. (Language: eng)

Reference: 2002-; vol 9 (issue 2) : pp 94-110

Dates: Created 2002/08/14; Completed 2003/03/03; Revised 2006/11/15;

PMID: 12174535, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

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