Prosthodontic decision-making: what unprompted information do dentists seek before prescribing treatment?

This study explored the nature of the unprompted information that clinicians seek before making a treatment decision and whether this decision corresponded with the clinical parameters of the case. Interns, general practitioners (GP) and prosthodontists (n = 70, mean age 33 years, range 23-68) were presented with a written vignette of partial edentulism that included two spaces and were invited to ask any questions for the purpose of making a treatment recommendation. A list of 48 potential question/answer items was available to the interviewer, of which 38 were asked. These were then allotted to four thematic categories. Mean number of questions asked did not differ significantly amongst groups, although prosthodontists asked significantly more questions in the 'clinical and radiographic information' category than GPs (P = 0.0001) and interns (P = 0.003). The relationship between a prescribed treatment and questions asked was tested by dichotomizing all recommendations into 'possible' or 'not possible' based on the authors' knowledge of the actual case history. There were no significant differences amongst the groups in the frequency of prescribing 'possible' treatment (Pearson chi-square 0.083 and 0.108 for upper and lower spaces, respectively), but those who prescribed 'possible' treatment asked significantly more questions in the 'clinical and radiographic information' category, specifically about bone adequacy in the edentulous areas: upper jaw (P = 0.0001) and lower jaw (P = 0.003). It may be concluded that prosthodontists generally opted for more 'possible' treatments, as well as seeking items of information that seemed to improve the chance of making recommendations that conformed to the actual case characteristics.