Galarneau C, Brodeur J M
Faculté de médecine, Université de Montréal.
J Can Dent Assoc. 1998 Nov;64(10):718-25.
It has been recognized that the diagnosis and treatment of caries vary so widely among dentists that patients increasingly feel the need to inform themselves and to compare recommended treatments before accepting one. This phenomenon is all the more present in pit and fissure surfaces intervention choices, where there is a wide variety of available treatments. This article will attempt to highlight the factors explaining the pit and fissure treatment variation. The lack of knowledge on pit and fissure sealant effectiveness and indications as well as dentists' clinical experiences have given rise to different myths and prejudices that have had an impact on the variability of treatment decision making. When in doubt about the necessity to execute a treatment, each decision to withhold treatment results in an incomplete care episode. A dentist's lack of comfort with withholding treatment may stop him from offering preventive care and cause him to follow a restoration-oriented practice. It is therefore increasingly urgent to achieve agreement among dentists, especially as current knowledge on the subject is giving way to new research.
人们已经认识到,牙医对龋齿的诊断和治疗差异很大,以至于患者越来越觉得有必要在接受某种治疗之前先了解情况并比较推荐的治疗方法。这种现象在窝沟表面干预选择中更为明显,因为有各种各样的可用治疗方法。本文将试图突出解释窝沟治疗差异的因素。对窝沟封闭剂有效性和适应症的认识不足以及牙医的临床经验导致了不同的误解和偏见,这些误解和偏见影响了治疗决策的可变性。当对是否有必要进行治疗存在疑问时,每一个不进行治疗的决定都会导致护理过程不完整。牙医对不进行治疗缺乏信心可能会阻止他提供预防性护理,并导致他采取以修复为主的治疗方式。因此,牙医之间达成共识变得越来越紧迫,尤其是因为目前关于这个主题的知识正在被新的研究所取代。