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Lower third molar treatment planning ability of general dental practitioners and oral maxillofacial surgeons using receiver operating characteristics methodology.

A comparison of lower third molar treatment planning ability of six oral and maxillofacial surgeons (three consultants, two senior registrars and one senior house officer) and 27 general dental practitioners was carried out using Receiver Operating Characteristics (ROC) methodology. Each clinician was presented with the same series of 50 case histories and asked to indicate, using a rating scale, how certain they were that each lower third molar required removal. These data, together with NIH gold standard treatment decisions for each third molar, were then used to construct ROC curves for each clinician and, using combined data, to produce ROC curves for the groups of hospital specialists and general dental practitioners. These curves were then compared statistically. There were significant differences between the best and worst practitioners, both in the hospital service and within general dental practice. When combined data were examined, however, there was no statistical difference in the treatment planning ability of hospital specialists and general dental practitioners. These findings indicate that lower third molar treatment planning ability is more dependent upon individual factors than specialist training. Further, the data presented here suggest that general dental practitioners are as capable of treatment planning for lower third molars as the specialists to whom they refer.

Clinical Competence↗

The use by general dental practitioners of an oral pathology diagnostic service over a 20-year period: the Birmingham Dental Hospital experience.

OBJECTIVE: To investigate the use of an oral pathology service by general dental practitioners over a 20-year period. DESIGN: Retrospective analysis of the number of cases received for histological examination in 1975, 1984 and 1994. SETTING: Birmingham Dental Hospital. SUBJECTS AND METHODS: 1101, 2395 and 3366 specimens were accessed respectively for the three years studied. Number and proportion of specimens received, number and proportion that were hard or soft tissue specimens and the information on the request form were recorded. A comparison was made between the provisional clinical and histological diagnoses. RESULTS: Although the number of specimens accessed increased approximately 3-fold, the number of specimens accessed from general dental practitioners increased 5-fold. The variety of histological categories increased by over 50%, most being soft tissue specimens. The number of correct provisional diagnoses increased steadily but the percentage with inappropriate provisional diagnoses remained the same. Information on request forms steadily improved. CONCLUSIONS: The increased number of specimens received from general dental practitioners over the 20-year period reflects an increased demand for an oral pathology diagnostic service. The referral pattern most likely indicates an increased awareness by general dental practitioners of the need to biopsy lesions arising within the oral cavity.

Biopsy↗

A UK perspective.

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Anesthesia, Dental↗

Primary dentition.

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Child, Preschool↗

Primary dentition.

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Cariostatic Agents↗

The current working patterns and future career aspirations of specialist trainees in dentistry.

OBJECTIVES: To determine current demographic details of dental specialist registrars in the UK, to examine their current working patterns and ascertain their future career aspirations. METHODS: A cross-sectional survey, using a self-administered postal questionnaire of all 418 dental specialist registrars (SpRs) in the UK. RESULTS: The response rate was 78%. Of the SpRs who responded 59% were male, the majority were aged under 36, 54% were married and over one third had dependants. Orthodontics had the greatest number of SpRs with 141, followed by maxillofacial surgery (70) and restorative dentistry (52). On completion of training, 80% of SpRs intended to work full time. Significantly more women intended to work part-time. Only a fifth of SpRs said they would consider an academic appointment compared with 54% for specialist practice. Three quarters intended to work partly in the public sector and partly in a private capacity. London was the most popular choice of location for a post in the future. Access to a wide range of clinical work, continuing professional development, autonomy and sociability were the most important factors when considering their future choice of career. CONCLUSION: Changes in the demographic profile of dental specialists and increasing opportunities for providing care within primary care may lead to difficulties in recruitment to academic and hospital posts. Increasing provision of specialist services in the 'high street' might improve access but could lead to inequalities unless these services are commissioned according to the needs of the population.

Adult↗

Conscious sedation.

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Anesthesia, Dental↗