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沙特国王大学牙科系第三磨牙外科拔除转诊系统评估。

Assessment of the referral system for surgical removal of third molars at the Dental Faculty, King Saud University.

机构信息

Oral and Maxillofacial Department, Dental Faculty, King Saud University, Riyadh, Saudi Arabia.

出版信息

Int Dent J. 2017 Dec;67(6):360-370. doi: 10.1111/idj.12321. Epub 2017 Aug 2.

Abstract

INTRODUCTION

There is compelling evidence that prophylactic extraction of third molars is a health problem that needs to be addressed. In particular, the vast amount of evidence demonstrating complications after removal of third molars, rather than supporting the necessity of removal or the negative effects of retention, raise this concern.

OBJECTIVE

The aim of this study was to investigate the referral system for third molar extraction at our institution by assessing patient opinions and the experience of the oral surgeons and the referring dentists. The main outcome measures of concern were the reasons for third molar extraction, patient awareness about the surgery and the comorbidities that may accompany the surgery.

METHODS

Pilot cross-sectional survey questionnaires were distributed at the Dental Faculty Clinic at King Saud University, from 15 March 2015 to 30 June 2016 by the staff in charge of the patient waiting area, oral surgery clinic, primary care clinic and specialist clinic.

RESULTS

Of 400 potential respondents, 226 completed the survey (response rate: 54%). Of these patients, 91% knew why they had been referred to the oral surgery department, but 73.5% did not understand the surgical extraction procedure or its complications. In total, 45.2% of the patients referred had no signs or symptoms, and 36% were referred for prophylactic reasons. In conclusion, our system needs reassessment. To combat the subjective health practice of routinely referring patients for prophylactic extraction, the role of primary care should be emphasised by implementing a system for regular patient check-ups, and public awareness should be increased.

摘要

引言

有确凿的证据表明,预防性拔除第三磨牙是一个需要解决的健康问题。特别是,大量证据表明第三磨牙拔除后会出现并发症,而不是支持拔除的必要性或保留的负面影响,这引起了人们的关注。

目的

本研究旨在通过评估口腔外科医生和转诊牙医的患者意见和经验,调查我们机构的第三磨牙拔除转诊系统。主要关注的结果测量指标是第三磨牙拔除的原因、患者对手术的认识以及可能伴随手术的并存疾病。

方法

2015 年 3 月 15 日至 2016 年 6 月 30 日,在沙特国王大学牙科系的候诊区、口腔外科诊所、初级保健诊所和专科诊所,由负责的工作人员分发了试点横断面调查问卷。

结果

在 400 名潜在受访者中,有 226 名完成了调查(应答率:54%)。这些患者中,91%知道为什么被转介到口腔外科部门,但 73.5%不了解手术拔除程序或其并发症。总的来说,45.2%转诊的患者没有任何迹象或症状,36%是预防性转诊。总之,我们的系统需要重新评估。为了对抗常规转介预防性拔除的主观健康做法,应通过实施定期患者检查系统来强调初级保健的作用,并提高公众意识。

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本文引用的文献

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Retention of Asymptomatic Third Molars May be Unwise.
J Evid Based Dent Pract. 2016 Mar;16(1):47-9. doi: 10.1016/j.jebdp.2016.01.010. Epub 2016 Jan 28.
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Recommendations for third molar removal: a practice-based cohort study.第三磨牙拔除建议:基于实践的队列研究。
Am J Public Health. 2014 Apr;104(4):735-43. doi: 10.2105/AJPH.2013.301652. Epub 2014 Feb 13.
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Pattern of third molar impaction in a Saudi population.沙特人群中第三磨牙阻生模式。
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