Influence of patient characteristics on Finnish dentists' decision-making in implant therapy

The purpose of this survey was to evaluate the association of various patient characteristics or possible contraindications with dentists' treatment decisions in oral implantology among general practitioners (GPs) and dental teachers (DTs) in Finland. A questionnaire was mailed to 400 GPs, selected by stratified randomization by gender and main occupation (public vs private sector), and to all full-time DTs (n = 47) representing clinical disciplines other than surgery and orthodontics. The questionnaire included a clinical description of a situation optimal for implant therapy. The same situation was modified with 10 variations (cases) according to patient characteristics or possible contraindications, later classified into three categories: (1) oral factors, (2) medical factors, and (3) personal factors. Respondents were asked whether or not they would recommend implant therapy for each of the cases separately. For all 10 cases, the public sector dentists recommended implant therapy on average for 48%, the private sector dentists for 57% (P < 0.01), and the DTs for 50%. For cases with periodontal pockets or untreated caries lesions, the private sector dentists recommended implant therapy more frequently than did the public sector dentists (27 vs 16%, P = 0.01, 46 vs 26%, P = 0.000, respectively). In the case of a smoking patient, 15% of DTs, but almost half of the GPs, recommended implant therapy (P = 0.002). Because some treatment decisions in implant therapy varied so widely between the dentist groups surveyed, a national database of dental implants would offer an important forum for the sharing of information and evidence among clinicians in various countries.