Longitudinal comparison of factors influencing choice of dental treatment by private general practitioners

Background: Service rate variations and appropriateness of care issues have focused attention on factors that influence treatment decisions. The aims of this study were to examine what factors dentists consider in choosing alternative treatments, the stability of these factors over time and whether stability of treatment choice was related to age of dentist. Methods: Baseline data were collected by mailed self-complete questionnaires from a random sample of Australian dentists (response rate=60.3 per cent, n=345 private general practitioners provided service data from a typical day) in 1997-1998 and followup data were collected in 2004 (response rate=76.8 per cent, n=177 matched longitudinal cases). Results: The most frequent factors considered important across six alternative treatment pair choice scenarios were caries rate for exam v. x-ray, age of patient for preventive v. restorative intervention, cost of treatment for crown v. buildup, root canal v. extraction and bridge v. denture, and calculus for prophylaxis v. scaling. The only differences over time were (t-test, P<0.05): higher proportions of responses in the mouth status group at follow-up for exam v. x-ray; higher proportions of responses in the visit history group at follow-up for preventive v. restorative intervention; a lower proportion of responses in the caries group at follow-up for crown v. build-up; and a higher proportion of responses in the treatment constraints group at follow-up for prophylaxis v. scaling. Conclusions: While a wide range of responses were offered as factors influencing the choice of alternative treatments, cost of treatment was a major consideration in situations where significantly cheaper alternatives existed, while patient preference was commonly included as a secondary consideration across a wide range of treatment choice scenarios. The treatment choice responses showed a high degree of stability over time across all age groups of dentists, suggesting that if routines are developed these are established before or soon after graduation as a dentist.

Brennan DS, Spencer AJ

Aust Dent J 2006;51(1):78-85.

This article has been reproduced with permission from the Australian Dental Journal.

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