儿科牙医与普通牙科医生在儿童牙科护理中的护理模式比较。
A comparison of paediatric dentists' and general dental practitioners' care patterns in paediatric dental care.
作者信息
Schorer-Jensma M A, Veerkamp J S J
机构信息
Department of Cariology, Endodontology and Paedodontology, Academic Centre of Dentistry Amsterdam [ACTA], EA Amsterdam, The Netherlands.
出版信息
Eur Arch Paediatr Dent. 2010 Apr;11(2):93-6. doi: 10.1007/BF03262719.
AIM
The aim of this study was to compare the care patterns of paediatric dentists and general dentists in the dental treatment of children in the Netherlands.
STUDY DESIGN AND METHODS
A case control study was completed based on the financial records of one of the largest Dutch health insurance companies. After medical ethical approval the dental records from 2004, 2005 and 2006 of 16 paediatric dentists were used and compared with the records of general practitioners with the same number of insured paediatric patients from the same age and urbanisation level. Preventive, diagnostic and restorative care for four consecutive age groups (<6, 6-8, 9-11, 12-17 yrs) were used as independent variables. Differences between the dentists and the age groups were tested with the Independent-Sample t-Test and ratios were calculated.
RESULTS
Compared with general dentists, paediatric dentists use statistically significant more often rubber-dam (p=0.009) and did more preventive treatments (p<0.001) in children up to aged 11 yrs, more extractions (p<0.001), took more radiographs (p=0.027) and used local analgesia more often (p=0.002) in children until aged 8 yrs and performed more restorations (p=0.02) in children up to 6 yrs of age. There was no significant difference in the care pattern of the dentists for the oldest age group (12-17 yrs). The care-index for paediatric dentists and general dentists from this research was comparable with Dutch epidemiological studies.
CONCLUSION
Compared with general dentists, paediatric dentists have a more extensive treatment approach when treating children. In the youngest age groups the differences are the most pronounced. Further studies are needed to clarify whether the cause is the needs of the patient or an attitude of supervised neglect by the general dentists.
目的
本研究旨在比较荷兰儿科牙医和普通牙医对儿童进行牙科治疗的护理模式。
研究设计与方法
基于荷兰最大的一家健康保险公司的财务记录完成了一项病例对照研究。经医学伦理批准后,使用了16名儿科牙医2004年、2005年和2006年的牙科记录,并与具有相同数量来自相同年龄和城市化水平的参保儿童患者的全科医生记录进行比较。将四个连续年龄组(<6岁、6 - 8岁、9 - 11岁、12 - 17岁)的预防性、诊断性和修复性护理作为自变量。使用独立样本t检验来检验牙医和年龄组之间的差异,并计算比率。
结果
与普通牙医相比,儿科牙医在11岁及以下儿童中更频繁地使用橡皮障(p = 0.009),进行更多的预防性治疗(p < 0.001),更多的拔牙操作(p < 0.001),在8岁及以下儿童中更频繁地拍摄X光片(p = 0.027),更频繁地使用局部麻醉(p = 0.002),并且在6岁及以下儿童中进行更多的修复治疗(p = 0.02)。对于最大年龄组(12 - 17岁),牙医的护理模式没有显著差异。本研究中儿科牙医和普通牙医的护理指数与荷兰的流行病学研究相当。
结论
与普通牙医相比,儿科牙医在治疗儿童时采用更广泛的治疗方法。在最年幼的年龄组中差异最为明显。需要进一步研究以阐明原因是患者的需求还是普通牙医监督不力的态度。