Dentistry: Evidence-practice gap for sealant application

In this study, the researchers aimed to examine dentist practice patterns regarding treatment recommendation of dental sealants and identify characteristics associated with this recommendation. The study was conducted using a cross-sectional questionnaire survey in Japan. Participants were Japanese dentists (N=282) recruited from the Japanese Dental Practice Based Research Network (JDPBRN) who indicated that they do at least some restorative dentistry. Scenarios, images and questionnaire items were the same as those used in a previous U.S. DPBRN study. A series of three clinical photographs of the occlusal surface of a mandibular first molar, together with a description, were presented portraying increasing depths of cavitation. The researchers inquired about the treatment decision for each case, which had a 12-year-old patient with high caries risk. Chi-square tests were performed to assess the association between belief about the effectiveness of caries risk assessment and sealant recommendation. Multiple logistic regression analysis were conducted to evaluate the association between the decision to recommend sealants and dentist, practice and patient characteristics.

Responses were obtained from 189 dentists (67 percent). In the hypothetical scenarios, dentists' recommendations of sealants for the 12-year old patient varied from 16 percent to 26 percent. Nineteen percent of dentists recommended sealants in the absence of dark brown pigmentation. Forty-eight percent of dentists (n=91) recommended sealants to more than 25 percent of patients ages 6-18 years. Multiple logistic regression analysis suggested that the dentist's belief in the effectiveness of caries risk assessment was significantly associated with the percentage of patients who would receive sealants. Dentist practice patterns for sealant treatment recommendation vary widely. Recommending a sealant was significantly related to the dentist having a higher belief about the effectiveness of caries risk assessment.

This researchers was support by NIH grants U01-DE-16746, U01-DE-16747 and U19-DE-22516.

This is a summary of oral presentation #0982, "Evidence-Practice Gap for Sealant Application: Results from a Dental PBRN."