Factors influencing the periodontal referral process.

BACKGROUND: General dental practitioners (GPs) assess the periodontal status of patients and make decisions to treat patients or refer them to a periodontist. There is little information available regarding this process. The purpose of this study is to identify significant factors that GPs consider important in selecting a particular periodontist. The findings were compared and contrasted with responses of periodontists to gain perspectives from both groups involved in the referral process. METHODS: Data from an online cross-sectional survey of GPs (n = 533) and periodontists (n = 533) who practice in the southeastern region of the United States (from the databases of the American Dental Association and American Academy of Periodontology member directories) were obtained. RESULTS: The specialist's clinical skill was identified as the most important factor influencing periodontal referrals by GPs, whereas periodontists identified a previous positive experience between a GP and periodontist as the most important factor. In a descending order of importance, the top three rating averages (rated out of five) by GPs were clinical skill (4.84), a previous positive experience between a GP and periodontist (4.57), and communication (4.52). The top three factors of periodontists were a previous positive experience between a GP and periodontist (4.66), communication (4.40), and the likelihood of a good patient and periodontist rapport (4.29). CONCLUSIONS: The periodontist's clinical skill was chosen by GPs as the primary factor influencing the referral decisions of GPs. Periodontists perceived a previous positive experience between the GP and periodontist as the most influential factor. Further studies are required to gain more insight into the referral process.

Patient-applied treatment of dentinal hypersensitivity.

This article reviews the evidence regarding the effectiveness of various patient-applied interventions for dentinal hypersensitivity. Self-applied treatments are popular because they are both economical and easy to use. The disadvantages include compliance, difficulty to deliver to specific sites, slow onset of action, and the requirement for continuous use. Conflicting research findings make it difficult for the practitioner to determine which self-applied product to advise patients to use. There are a number of issues that have plagued research in this area, including the lack of standardization of stimulus testing and inadequate sample size. The evidence is insufficient to permit the development of evidence-based guidelines for the treatment of dentinal hypersensitivity.

Effect of presentation bias on selection of treatment option for failed endodontic therapy.

OBJECTIVE: The purpose of the study was to determine if treatment option presentation bias affects decision making by patients when they have failed endodontic therapy. STUDY DESIGN: First-year dental students simulated the role of patients. All students were given the same scenario of a symptomatic tooth with failed endodontic therapy and asked to select from between 2 treatment options: nonsurgical endodontic retreatment or extraction and implant placement. One half of the students had characterizations of the treatment options biased toward nonsurgical retreatment, and the other half had characterizations of the treatment options biased toward extraction and implant selection. Statistical analysis was performed with chi-squared test. RESULTS: Biased presentations significantly influenced the treatment selection by the students (P = .0006). CONCLUSION: If treatment options are presented in a biased manner to favor one option, the patient is more likely to select that treatment option.