Widström E, Sundberg H
Department of Community Dentistry, University of Kuopio, Finland.
Swed Dent J. 1991;15(4):153-60.
During the past 10-15 years the possible side-effects of dental restorative materials, especially due to amalgam fillings, have caused a lively debate in Sweden. There is an extensive literature on the chemical and biological properties of dental materials but no investigations have dealt with the providers' attitudes. The purpose of this study was to find out the dentists' experiences of and attitudes to patients who state they have problems related to dental restorative materials and compare the dentists' subjective assessments of those side-effects in two neighboring countries, Finland and Sweden. Information was collected by postal questionnaires addressed to dentists chosen at random in Finland (n = 625) and in Sweden (n = 960). The response rate was 73 per cent and 72 per cent respectively. The results showed that 99 per cent of the respondents had patients questioning the safety of dental materials. The number of such patients was estimated to be three times higher in Sweden (124 patients per dentist in 1989) than in Finland (39 patients per dentist). More than 90 per cent of the questions from the patients regarded amalgam fillings. Statistically significant differences were found between the respondents' opinions of amalgam, 81 per cent of the Finnish contrary to 59 per cent of the Swedish respondents considered the risk of side-effects to be low when using this material. About 90 per cent of the respondents considered glass-ionomer, gold and ceramic restorations safe, but only half of them were convinced of the safety of composite. A great majority of the Swedish respondents (79 per cent) claimed that the patients should get their fillings changed without odontologic indications if they insisted on it and paid for the treatment in comparison to 22 per cent of the Finnish respondents (p less than 0.001). In case dental insurance was to pay for this kind of treatment it was accepted by 6 per cent of the Finns and 25 per cent of the Swedes. The attitude to amalgam was in general less favorable among the dentists in Sweden than in Finland.
在过去的10到15年里，牙科修复材料可能产生的副作用，尤其是汞合金填充物带来的副作用，在瑞典引发了一场激烈的争论。关于牙科材料的化学和生物学特性有大量文献，但尚未有研究涉及提供者的态度。本研究的目的是了解牙医对于声称与牙科修复材料有关问题的患者的经验和态度，并比较芬兰和瑞典这两个邻国的牙医对这些副作用的主观评估。通过向芬兰（n = 625）和瑞典（n = 960）随机选择的牙医邮寄调查问卷来收集信息。回复率分别为73%和72%。结果显示，99%的受访者有患者质疑牙科材料的安全性。据估计，这类患者的数量在瑞典（1989年每位牙医有124名患者）比在芬兰（每位牙医39名患者）高出三倍。患者提出的问题中超过90%涉及汞合金填充物。在受访者对汞合金的看法上发现了统计学上的显著差异，81%的芬兰受访者与59%的瑞典受访者相反，认为使用这种材料时副作用风险较低。约90%的受访者认为玻璃离子、金和陶瓷修复体是安全的，但只有一半的人确信复合材料的安全性。绝大多数瑞典受访者（79%）声称，如果患者坚持且自费治疗，即使没有牙科适应症也应该更换填充物，相比之下，芬兰受访者中这一比例为22%（p小于0.001）。如果牙科保险要支付这种治疗费用，6%的芬兰人和25%的瑞典人会接受。总体而言，瑞典牙医对汞合金的态度不如芬兰牙医那么积极。
