Whitworth J M, Seccombe G V, Shoker K, Steele J G
Department of Restorative Dentistry, Newcastle Dental School, Framlington Place, Newcastle, NE3 3DE, UK.
Int Endod J. 2000 Sep;33(5):435-41. doi: 10.1046/j.1365-2591.2000.00329.x.
To evaluate factors which influence rubber dam use and irrigant selection in UK National Health Service (NHS) endodontics.
A postal survey was conducted amongst two age cohorts of dentists, representing all of the 1970-73 (older) and 1990-93 (younger) graduates of two northern English dental schools (n = 643). Key and supplementary questions were posed on levels of rubber dam use, irrigant selection, and factors influencing practice in NHS endodontics. After manual checking, validated (dual) entry of responses was made to a flat ASCII data file before analysis with SPSS software. The threshold for statistical significance was set at the 95% probability level.
Eighty-five per cent of the valid sample responded to the questionnaire. Regardless of age and qualifying school, less than one-fifth of dentists always or frequently used rubber dam, whilst 60% never used it. Qualifying school had a significant influence on rubber dam use, whilst age had a variable influence. Major disincentives to the use of rubber dam included the perception that patients do not like it, that the NHS fee was inadequate to justify its use, that it took too long to apply, and that dentists had received inadequate training. Frequent users of rubber dam were significantly less likely to cite these disincentives than nonusers. Overall, local anaesthetic solution was the most common endodontic irrigant. Irrigant choice was strongly linked to rubber dam use, and to graduation cohort. Seventy-one per cent of rubber dam users irrigated with sodium hypochlorite, compared with only 38% of nonusers. This pattern was reversed for local anaesthetic irrigation. Younger graduates were significantly more likely to irrigate with local anaesthetic solution than their older counterparts, and the younger graduates of one school showed a highly significant increase in the use of chlorhexidine.
评估影响英国国家医疗服务体系(NHS)牙髓病治疗中橡皮障使用和冲洗剂选择的因素。
对两个年龄组的牙医进行了邮寄调查,这些牙医代表了英国北部两所牙科学校1970 - 1973年毕业的所有(年长组)和1990 - 1993年毕业的所有(年轻组)毕业生(n = 643)。提出了关于橡皮障使用水平、冲洗剂选择以及影响NHS牙髓病治疗实践因素的关键问题和补充问题。人工检查后,将经过验证(双重)录入的回复录入到一个纯ASCII数据文件中,然后使用SPSS软件进行分析。统计学显著性阈值设定为95%概率水平。
有效样本中有85%回复了问卷。无论年龄和毕业学校如何,不到五分之一的牙医总是或经常使用橡皮障,而60%的牙医从未使用过。毕业学校对橡皮障的使用有显著影响,而年龄的影响则各不相同。使用橡皮障的主要阻碍因素包括认为患者不喜欢、NHS费用不足以证明其使用合理性、应用时间过长以及牙医接受的培训不足。橡皮障的频繁使用者比非使用者更不太可能提及这些阻碍因素。总体而言,局部麻醉剂溶液是最常用的牙髓冲洗剂。冲洗剂的选择与橡皮障的使用以及毕业队列密切相关。71%的橡皮障使用者用次氯酸钠冲洗,相比之下,非使用者仅为38%。局部麻醉剂冲洗的情况则相反。年轻毕业生比年长毕业生更有可能用局部麻醉剂溶液冲洗,而且一所学校的年轻毕业生在洗必泰的使用上有显著增加。
1)英国国家医疗服务体系的大多数牙医在牙髓病治疗中从不使用橡皮障隔离。2)毕业学校对橡皮障的使用和冲洗剂的选择有显著影响。3)橡皮障的使用与牙髓病治疗中冲洗剂的选择有显著关联。