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挪威牙医之间龋齿治疗方案的差异:儿童的最大利益。

Variation in caries treatment proposals among dentists in Norway: the best interest of the child.

作者信息

Rønneberg A, Skaare A B, Hofmann B, Espelid I

机构信息

Department of Paediatric Dentistry and Behavioural Science, Faculty of Dentistry, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway.

Section for Health, Technology and Society, The Norwegian University of Science and Technology (NTNU), Gjøvik, Norway.

出版信息

Eur Arch Paediatr Dent. 2017 Oct;18(5):345-353. doi: 10.1007/s40368-017-0298-4. Epub 2017 Jul 26.

Abstract

AIM

To explore variation in treatment-related-decisions for severe caries in children among dentists in the Public Dental Service (PDS) in Norway. It was also to evaluate the treatment choices in relation to the best interest of children and a child's rights to enjoy the highest standard of health care.

METHODS

A pre-coded questionnaire was sent electronically to all general dental practitioners (GDPs) working in the PDS in eight counties in Norway (n = 611). The questionnaire included two case scenarios to reflect common dental conditions related to severe caries among 5-year-old children. Paediatric dentists and paediatric students were invited to validate the different treatment options. Frequency distributions and statistical analyses were carried out using Chi square statistics.

RESULTS

The response rate was 65% (n = 391) among the GDPs. A majority of the GDPs preferred a new appointment with behaviour management techniques (BMT) to a child presenting pulpitis and pain. Dentists educated outside the Nordic region would use restraint more often as a treatment alternative when the child was in pain than Nordic-educated dentists (p\0.05). Dentists with less than 10 years of experience preferred BMT and sedation more often when the child was in pain than their older colleagues, who, however, preferred a waiting approach and no immediate treatment if the child was not in pain(p\0.05) [corrected].

CONCLUSIONS

Use of BMT and sedation is related to region of education and years of experience. Awareness of ethical principles with the child´s best interest in mind, should receive increased attention.

摘要

目的

探讨挪威公共牙科服务(PDS)中牙医对儿童重度龋齿治疗相关决策的差异。同时评估治疗选择是否符合儿童的最大利益以及儿童享有最高标准医疗保健的权利。

方法

通过电子邮件向挪威八个郡在PDS工作的所有普通牙科医生(GDPs)(n = 611)发送预先编码的问卷。问卷包含两个病例场景,以反映5岁儿童中与重度龋齿相关的常见牙科情况。邀请儿科牙医和儿科学生对不同的治疗方案进行验证。使用卡方统计进行频率分布和统计分析。

结果

GDPs的回复率为65%(n = 391)。大多数GDPs更倾向于为患有牙髓炎和疼痛的儿童安排新的预约并采用行为管理技术(BMT)。与在北欧地区接受教育的牙医相比,在北欧地区以外接受教育的牙医在儿童疼痛时更常将约束作为一种治疗选择(p<0.05)。经验少于10年的牙医在儿童疼痛时比年长的同事更常选择BMT和镇静,然而,年长的同事如果儿童不疼痛则更倾向于等待观察且不立即治疗(p<0.05)[校正后]。

结论

BMT和镇静的使用与教育地区和经验年限有关。应更加关注以儿童最大利益为出发点的伦理原则。

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