Raittio Eero, Grytten Jostein, Lopez Rodrigo, Blich Carl Christian, Vettore Mario Vianna, Baelum Vibeke
Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.
Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.
Community Dent Oral Epidemiol. 2025 Feb;53(1):1-6. doi: 10.1111/cdoe.13003. Epub 2024 Aug 15.
Clinical practice guidelines aim to enhance the quality, equality and consistency of care but often demand more time than is available, rendering adherence impractical and exceeding feasible resources. The 2017 introduction of a new periodontal classification system by the American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP) sought to refine clinical and epidemiological practices by serving as the basis for clinical practice guidelines and epidemiological investigations around the world. Following this classification, the EFP recommends supportive periodontal care visits every 3-12 months for all periodontitis cases. Given that in Norway, approximately 72% of the adult population are identified as periodontitis cases under the current AAP/EFP case definition, this poses a significant demand on healthcare resources. We calculated that between 60% and 70% of all estimated available working hours available for adult dental care provided by dentists and dental hygienists in Norway in 2017 would be spent on supportive periodontal care visits alone if the recommendations were to be met. This situation calls for a reevaluation of disease definitions and clinical practice guidelines to ensure they are practical, financially feasible and patient-outcome relevant.
临床实践指南旨在提高医疗服务的质量、公平性和一致性,但往往需要比实际可利用时间更多的时间,导致难以遵循,超出了可行资源的范围。美国牙周病学会(AAP)和欧洲牙周病学联合会(EFP)于2017年推出了新的牙周分类系统,旨在通过作为全球临床实践指南和流行病学调查的基础来完善临床和流行病学实践。根据这一分类,EFP建议所有牙周炎病例每3至12个月进行一次支持性牙周护理就诊。鉴于在挪威,按照当前AAP/EFP的病例定义,约72%的成年人口被认定为牙周炎病例,这对医疗资源提出了巨大需求。我们计算得出,如果要满足这些建议,2017年挪威牙医和口腔保健员为成人提供牙科护理的所有估计可用工作时间中,有60%至70%将仅用于支持性牙周护理就诊。这种情况需要重新评估疾病定义和临床实践指南,以确保它们切实可行、在财务上可行且与患者预后相关。