Main P A, Lewis D W, Hawkins R J
Department of Community Dentistry, Faculty of Dentistry, University of Toronto.
J Can Dent Assoc. 1997 Sep;63(8):607, 610-7.
A mail questionnaire was used to assess variations in the knowledge and practices of Ontario dentists with respect to topical fluoride and prophylaxis procedures. The questionnaire was answered by 1,276 general dentists. A high percentage (72 to 83 per cent) of respondents identified six months as the optimal time interval at which both procedures should be repeated for all patients under 19 years of age. Relatively few dentists (< 10 per cent) indicated that there should be no specific time interval for re-treatment (i.e. that it should be individually selected). The respondents' preventive knowledge was found to be deficient in two areas: few dentists (16 per cent) knew that it is not necessary to provide a prophylaxis prior to topical fluoride application to achieve maximum caries protection; and most dentists overestimated the speed of caries progress from outer enamel to the dentinoenamel junction (DEJ) in both primary (83 per cent) and permanent (82 per cent) approximal tooth surfaces. In bivariate analysis, three variables were found to be consistently and significantly related to optimal time intervals selected for both topical fluoride application and prophylaxis procedures: year of graduation from dental school; level of hygienist employment; and percentage of patients with private insurance. Multivariate analysis also identified three significant variables: year of graduation from dental school; level of dental hygienist employment; and practice business. Continuing education courses are suggested as a means of updating dentists' knowledge regarding preventive services. Studies are needed to determine the extent to which recent recommendations regarding the professional application of topical fluorides have been followed.
一份邮寄调查问卷被用于评估安大略省牙医在局部用氟化物和预防措施方面的知识和实践差异。1276名普通牙医回答了这份问卷。高比例（72%至83%）的受访者认为，对于所有19岁以下患者，这两种程序都应重复进行的最佳时间间隔是六个月。相对较少的牙医（不到10%）表示再治疗不应有特定的时间间隔（即应个别选择）。研究发现，受访者的预防知识在两个方面存在不足：很少有牙医（16%）知道在局部用氟化物之前不必进行预防以实现最大程度的防龋保护；大多数牙医高估了乳牙（83%）和恒牙（82%）邻面龋从外层牙釉质发展到牙釉质牙本质界（DEJ）的速度。在双变量分析中，发现有三个变量始终与为局部用氟化物应用和预防措施选择的最佳时间间隔显著相关：牙科学校毕业年份；口腔卫生员的就业水平；以及有私人保险的患者比例。多变量分析还确定了三个显著变量：牙科学校毕业年份；口腔卫生员的就业水平；以及业务实践情况。建议通过继续教育课程来更新牙医关于预防服务的知识。需要开展研究以确定近期有关局部用氟化物专业应用的建议在多大程度上得到了遵循。
