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常规口腔检查:基层医疗中全科牙医的临床操作与管理

Routine oral examination: clinical performance and management by general dental practitioners in primary care.

作者信息

Mettes Theodorus G, van der Sanden Wil J M, Mokkink Henk G, Wensing Michel, Grol Richard P T M, Plasschaert Alphons J M

机构信息

Radboud University Nijmegen Medical Center, College of Oral Sciences, Department of Preventive and Restorative Dentistry, Nijmegen, The Netherlands.

出版信息

Eur J Oral Sci. 2007 Oct;115(5):384-9. doi: 10.1111/j.1600-0722.2007.00472.x.

Abstract

The aim of this clinical study was to explore the contents of routine oral examinations (ROE), carried out by Dutch general dental practitioners (GDPs), in relation to the oral health status of regularly attending patients. An observational study was performed, based on clinical case recording. Using The Data Station Project of the Dutch Dental Association as the study base, 215 GDPs were recruited, of whom 131 participated in the study. A clinical case-recording form was developed to document clinical behavior. The contents assessed concerned patient characteristics, contents of the ROE visit, diagnoses made, and clinical behavior in response to ROE findings. This study showed substantial variation in clinical behavior related to specific ROE domains, including patient history and record keeping, whereas GDPs acted consistently on other domains, such as clinical examination and recall length assessment. Furthermore, the ROE performance was more strongly associated with GDP characteristics than with patient characteristics. The mean ROE time was 10 min, and recall intervals were most frequently assigned at 6 months, irrespective of the oral condition. This study highlights a need for continuing education to promote risk-based oral screening. Further research is needed to identify factors responsible for the variation in GDP performance, just as research on clinical practice guideline implementation methods is warranted.

摘要

这项临床研究的目的是探究荷兰普通牙科医生(GDPs)进行的常规口腔检查(ROE)内容与定期就诊患者口腔健康状况之间的关系。基于临床病例记录进行了一项观察性研究。以荷兰牙科协会的数据站项目为研究基础,招募了215名普通牙科医生,其中131名参与了研究。开发了一份临床病例记录表格来记录临床行为。评估的内容包括患者特征、ROE就诊内容、做出的诊断以及针对ROE结果的临床行为。这项研究表明,在与特定ROE领域相关的临床行为方面存在很大差异,包括患者病史和记录保存,而普通牙科医生在其他领域(如临床检查和复诊间隔评估)的行为则较为一致。此外,ROE表现与普通牙科医生的特征比与患者特征的关联更强。ROE的平均时间为10分钟,复诊间隔最常设定为6个月,无论口腔状况如何。这项研究凸显了开展继续教育以促进基于风险的口腔筛查的必要性。需要进一步研究以确定导致普通牙科医生表现差异的因素,正如对临床实践指南实施方法的研究也很有必要一样。

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