Changes in dentists' attitudes and practice in paediatric dentistry.

Area of Science:

• Dentistry
• Pediatric Dentistry
• Dental Public Health

Background:

• The introduction of capitation payments in the UK aimed to influence clinical practice in pediatric dental care.
• A decade-long study was conducted to assess changes in general dental practitioners' (GDPs) approaches to child dental care.

Purpose of the Study:

• To evaluate shifts in clinical practices and attitudes towards pediatric dental care among UK GDPs between 1986 and 1996.
• To determine the impact of the capitation payment system on these changes.

Main Methods:

• A questionnaire survey was administered to 1,290 GDPs in Yorkshire, UK.
• Practices in caries prevention, behavior management, primary tooth restoration, and pulp therapy were assessed.
• Responses were compared to identical survey data from 1986.

Main Results:

• Significant increases in preventive measures: diet evaluation (61%), oral hygiene instruction (87%), and fissure sealants (57%).
• A major shift in restorative materials: amalgam use decreased from 80% to 35%, with glass ionomer cements rising to 57%.
• Pulp therapy for primary teeth improved significantly (3% to 35%), while rubber dam use remained low (0% to 9%).

Conclusions:

• GDPs generally adopted more pediatric dental techniques, particularly in prevention and pulp treatment.
• Restorative techniques saw marginal changes, except for a substantial move away from amalgam.
• The study highlighted a continued underutilization of rubber dam and stainless steel crowns in pediatric dental care.