Humphreys Judith, Morgan Emma, Clayton Stephen, Jarad Fadi, Harris Rebecca, Albadri Sondos
Department of Paediatric Dentistry, University of Liverpool, UK.
Department of Public Health, Policy and Systems, University of Liverpool, UK.
Br Dent J. 2022 May 26:1-7. doi: 10.1038/s41415-022-4254-2.
Introduction Molar-incisor hypomineralisation (MIH) presents as a spectrum, with severe cases becoming increasingly complex to manage. This study aimed to investigate the perceptions and experience of general dental practitioners (GDPs) in England when managing children with MIH.Method Semi-structured telephone interviews with GDPs who regularly treat children took place in May 2020. A sample of four male and six female GDPs with 1-15 years of experience was achieved through purposively sampling interested parties following advertisement via professional groups. Thematic analysis using a realist and inductive approach was used in analysis.Results The overarching theme was of managing uncertainty, with four subthemes: setting the scene; fighting the tooth; working within the system; and self and interpersonal insight. Despite being knowledgeable, participants expressed varying levels of confidence in many aspects while managing children with MIH. There was a great deal of uncertainty surrounding 'doing the right thing' across the themes. Systemic barriers to managing children with MIH within the general dental service were identified.Conclusion The challenges of managing children with MIH was experienced as 'uncertainty'. Barriers within the general dental service made managing children with MIH difficult and participants relied on colleagues in secondary care to manage severe cases.
引言
磨牙-切牙矿化不全(MIH)表现为一系列症状,严重病例的管理变得越来越复杂。本研究旨在调查英格兰普通牙科医生(GDPs)在治疗患有MIH的儿童时的看法和经验。
方法
2020年5月,对经常治疗儿童的GDPs进行了半结构化电话访谈。通过专业团体发布广告后,有目的地对感兴趣的人士进行抽样,获得了4名男性和6名女性GDPs的样本,他们具有1至15年的工作经验。分析采用了现实主义和归纳法的主题分析。
结果
总体主题是管理不确定性,有四个子主题:营造氛围;与牙齿问题作斗争;在系统内工作;以及自我和人际洞察。尽管知识渊博,但参与者在管理患有MIH的儿童时,在许多方面表现出不同程度的信心。在各个主题中,围绕“做正确的事”存在大量不确定性。确定了普通牙科服务中管理患有MIH的儿童的系统性障碍。
结论
管理患有MIH的儿童面临的挑战被体验为“不确定性”。普通牙科服务中的障碍使得管理患有MIH的儿童变得困难,参与者依赖二级保健中的同事来管理严重病例。