Lee Jung Ho, Bennett Duane E, Richards Philip S, Inglehart Marita Rohr
Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI 48109-1078, USA.
J Dent Educ. 2009 Feb;73(2):199-210.
The objectives of this study were to investigate periodontal treatment and referral patterns and the considerations used in the process of dentists who make no periodontal referrals, relatively few referrals, or more referrals. Specifically, the role of disease characteristics, patient- and provider-related factors, attitudes towards periodontal referrals, and perceptions of dental education were explored. The relationships between the perceived quality of dental education concerning periodontal diagnosis and treatment and the considerations used in this process were evaluated as well. Data were collected from 160 members of the Michigan Dental Association using a mailed questionnaire. The respondents were predominantly male (77 percent) and white (96 percent) and had practiced for an average of twenty-three years (SD=10.7). While 13 percent of the respondents had not made any periodontal referrals during the past month, 69 percent had referred between one and five patients, and 18 percent more than five patients. Dentists who referred more than three patients per month considered the patients' oral hygiene as more important, had fewer patients from lower socioeconomic backgrounds and more patients with private insurance, and felt less well prepared by their dental education compared to general dentists who referred fewer than three patients per month to a periodontist. The more positively dentists evaluated their dental education in periodontics, the more conservative they were when considering percentage of bone loss as a basis for referral (r=.228; p=.014), the more frequently they used systemic antibiotics in their treatment of periodontal disease (r=.180; p=.036), and the more they considered whether their patients would return after the periodontal treatment (r=.185; p=.028) as a factor in their referral decisions. General dentists' perceptions of the quality of their dental school education in periodontics decreased their willingness to refer patients and increased their desire to treat these patients in their own practices. Future research should analyze the ways in which dental school curricula could prepare students to make timely and necessary periodontal referrals.
本研究的目的是调查牙周治疗及转诊模式，以及不进行牙周转诊、转诊较少或转诊较多的牙医在转诊过程中所考虑的因素。具体而言，探讨了疾病特征、患者及提供者相关因素、对牙周转诊的态度以及对牙科教育的认知等方面的作用。同时评估了牙周诊断和治疗方面牙科教育的感知质量与该过程中所考虑因素之间的关系。通过邮寄问卷从密歇根牙科协会的160名成员中收集数据。受访者以男性为主（77%），白人（96%），平均从业23年（标准差 = 10.7）。在过去一个月中，13%的受访者未进行任何牙周转诊，69%的受访者转诊了1至5名患者，18%的受访者转诊超过5名患者。与每月转诊少于3名患者至牙周科的普通牙医相比，每月转诊超过3名患者的牙医认为患者的口腔卫生更为重要，来自社会经济背景较低的患者较少，拥有私人保险的患者较多，并且觉得牙科教育对他们的准备不足。牙医对牙周病学牙科教育的评价越积极，在将骨丧失百分比作为转诊依据时就越保守（r = 0.228；p = 0.014），在治疗牙周病时使用全身抗生素的频率越高（r = 0.180；p = 0.036），并且在转诊决策中越会考虑患者在牙周治疗后是否会回来（r = 0.185；p = 0.028）。普通牙医对牙周病学牙科学校教育质量的认知降低了他们转诊患者的意愿，并增加了他们在自己诊所治疗这些患者的欲望。未来的研究应分析牙科学校课程如何能够让学生做好准备，以便及时进行必要的牙周转诊。
