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The impact of dental phobia on care planning: a vignette study

Abstract

Introduction A high percentage of people with dental phobia have poor oral health. This may be the result of delayed treatment or differences in care planning by the oral health care team.

Aim This study sought to determine the effect, if any, of dental phobia and complexity of dental care on the proposed care plan devised by clinicians for patients.

Design An experimental analogue study with independent variables of the presence of phobia and complexity of treatment need. Dependent variables included frequency of care planning elements such as periodontal treatment, prevention, restorations, root canal treatment, extraction and provision of crowns, bridges and prostheses.

Participants Seventy-nine UK-based dental practitioners.

Analysis The association between the case status (phobic versus non-phobic, simple versus complex) and the outcome variables were assessed using a chi-square test for association. Logistic regression analyses were also used to determine the predictors of care planning elements.

Results There were no differences in care planning for phobic and non-phobic patients. Complexity of treatment need had significant effects on advanced periodontal treatment, restorations anterior and posterior, root canal treatment, provision of crowns, and extractions.

Conclusions Care planning is influenced by patients' dental needs and not their phobic status.

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References

  1. 1.

    Chenery V, O 'Sullivan I, Lader D. Adult Dental Health Survey 2009 - England Key Findings. 2011. Available at https://files.digital.nhs.uk/publicationimport/pub01xxx/pub01086/adul-dent-heal-surv-summ-them-eng-2009-re11.pdf (accessed March 2019).

  2. 2.

    Heidari E, Banerjee A, Newton J T. Oral health status of non-phobic and dentally phobic individuals; A secondary analysis of the 2009 Adult Dental Health Survey. Br Dent J 2015; 219: E9.

  3. 3.

    Heidari E, Andiappan M, Banerjee A, Newton J T. The oral health of individuals with dental phobia: A multivariate analysis of the Adult Dental Health Survey, 2009. Br Dent J 2017; 222: 595-604.

  4. 4.

    Weinstein P, Milgrom P, Ratener P, Morrison K. Patient dental values and their relationship to oral health status, dentist perceptions and quality of care. Community Dent Oral Epidemiol 1979; 7: 121-127.

  5. 5.

    O'Toole S, Pennington M, Varma S, Bartlett D W. The treatment need and associated cost of erosive tooth wear rehabilitation - a service evaluation within an NHS dental hospital. Br Dent J 2018; 224: 957-961.

  6. 6.

    Schuller A A, Willumsen T, Holst D. Are there differences in oral health and oral health behaviour between individuals with high and low dental fear? Community Dent Oral Epidemiol 2003; 31: 116-121.

  7. 7.

    Hill K B, Hainsworth J M, Burke F J T, Fairbrother K J. Evaluation of dentists' perceived needs regarding treatment of the anxious patient. Br Dent J 2008; 204: E13.

  8. 8.

    Peabody J W, Luck J, Glassman P et al. Measuring the quality of physician practice by using clinical vignettes: a prospective validation study. Ann Intern Med 2004; 141: 771-780.

  9. 9.

    Bachmann L M, Mühleisen A, Bock A, ter Riet G, Held U, Kessels A G. Vignette studies of medical choice and judgement to study caregivers' medical decision behaviour: systematic review. BMC Med Res Methodol 2008; 8: 50.

  10. 10.

    Evans S C, Roberts M C, Keeley J W et al. Vignette methodologies for studying clinicians' decision-making: Validity, utility, and application in ICD11 field studies. Int J Clin Health Psychol 2015; 15: 160-170.

  11. 11.

    Bader J D, Shugars D A. What do we know about how dentists make caries-related treatment decisions? Community Dent Oral Epidemiol 1997; 25: 97-103.

  12. 12.

    Grilli R, Lomas J. Evaluating the message: the relationship between compliance rate and the subject of a practice guideline. Med Care 1994; 32: 202-213.

  13. 13.

    Akbarali N, Boyle C, Newton J T. Appropriate referrals to Special Care Dentistry: a retrospective study. J Disabil Oral Health 2009; 10: 142-150.

  14. 14.

    General Dental Council. Standards for the Dental Team. 2013. Available at https://www.gdc-uk.org/api/files/NEW%20Standards%20for%20the%20Dental%20Team.pdf (accessed March 2019).

  15. 15.

    Chipchase S Y, Chapman H R, Bretherton R. A study to explore if dentists' anxiety affects their clinical decision-making. Br Dent J 2017; 222: 277-290.

  16. 16.

    Goumans C, Veerkamp J S, Aartman I H. Dental anxiety and behavioural problems: what is their influence on the treatment plan? Eur J Paediatr Dent 2004; 5: 15-18.

  17. 17.

    De Jongh A, Adair P, Meijerink-Anderson M. Clinical management of dental anxiety: what works for whom? Int Dent J 2005; 55: 73-80.

  18. 18.

    Heidari E, Banerjee A, Newton T. Survey of treatment policies under conscious sedation at centres dealing with people with high levels of dental anxiety across the United Kingdom. Br Dent J 2018; 224: 632-636.

  19. 19.

    Kani E, Asimakopoulou K, Daly B et al. Characteristics of patients attending for cognitive behavioural therapy at one UK specialist unit for dental phobia and outcomes of treatment. Br Dent J 2015; 219: 501-506.

  20. 20.

    Eccles M, Grimshaw J, Walker A, Johnston M, Pitts N. Changing the behaviour of healthcare professionals: The use of theory in promoting the uptake of research findings. J Clin Epidemiol 2005; 58: 107-112.

  21. 21.

    Grol R, Grimshaw J. From best evidence to best practice: effective implementation of change in patients' care. Lancet 2003; 362: 1225-1230.

  22. 22.

    Godin G, Bélanger-Gravel A, Eccles M, Grimshaw J. Healthcare professionals' intentions and behaviours: A systematic review of studies based on social cognitive theories. Implement Sci 2008; 3: 36.

  23. 23.

    Taylor B J. Factorial surveys: using vignettes to study professional judgement. Br J Soc Work 2006; 36: 1187-1207.

  24. 24.

    Adams A S, Soumerai S B, Lomas J, Ross-Degnan D. Evidence of self-report bias in assessing adherence to guidelines. Int J Qual Health Care 1999; 11: 187-192.

  25. 25.

    Chapple H, Shah S, Caress A L, Kay E J. Exploring dental patients' preferred roles in treatment decision-making - a novel approach. Br Dent J 2003; 194: 321-327.

  26. 26.

    Rouse R A, Hamilton M A. Dentists evaluate their patients: an empirical investigation of preferences. J Behav Med 1991; 14: 637-648.

  27. 27.

    Cook J V, Dickinson H O, Eccles M P. Response rates in postal surveys of healthcare professionals between 1996 and 2005: an observational study. BMC Health Serv Res 2009; 9: 160.

  28. 28.

    Hakeberg M, Berggren U, Carlsson S G. Prevalence of dental anxiety in an adult population in a major urban area in Sweden. Community Dent Oral Epidemiol 1992; 20: 97-101.

  29. 29.

    Poulton R, Waldie K E, Thomson W M, Locker D. Determinants of earlyvs late-onset dental fear in a longitudinal-epidemiological study. Behav Res Ther 2001; 39: 777-785.

  30. 30.

    Moore R, Birn H, Kiregaard E, Brodsgaard I, Scheutz F. Prevalence and characteristics of dental anxiety in Danish adults. Community Dent Oral Epidemiol 1993; 21: 292-296.

  31. 31.

    Hill K B, Chadwick B, Freeman R, O'Sullivan I, Murray J J. Adult Dental Health Survey 2009: relationships between dental attendance patterns, oral health behaviour and the current barriers to dental care. Br Dent J 2013; 214: 25-32.

  32. 32.

    Banerjee A. 'Minimum intervention' - MI inspiring future oral healthcare? Br Dent J 2017; 223: 133-135.

  33. 33.

    Banerjee A. Implementing minimum intervention (MI) oral healthcare delivery - overcoming the hurdles. Prim Dent J 2017; 6 (Spec Iss): 28-32.

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Acknowledgements

The authors would like to thank all the participants in this study.

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Correspondence to Ellie Heidari.

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Heidari, E., Newton, J., Andiappan, M. et al. The impact of dental phobia on care planning: a vignette study. Br Dent J 226, 581–587 (2019). https://doi.org/10.1038/s41415-019-0203-0

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