Influence of specialty training and experience on endodontic decision making

The purpose of this study was to compare decision-making choices among dentists with different levels of training.

Scanned periapical radiographs and a leaflet with relevant information of 17 endodontically treated teeth were mailed to 40 undergraduate students, 25 general practitioners, 20 postgraduate students, and 40 endodontists. All teeth were symptom-free. The hypothetical scenario referred to patients who sought treatment for first time and had noncontributory medical history. Five treatment options were given for each situation: (1) Extraction, (2) Surgical Retreatment, (3) Nonsurgical Retreatment, (4) Wait and See, and (5) No Therapy. Statistical analysis was performed by using multinomial logistic regression models.

The overall response rate was 70.4%, with endodontists exhibiting the lowest response. The undergraduates gave 4 or 5 treatment solutions for all cases, in contrast to endodontists, who gave 2 or 3 treatment solutions in a percentage of 82%. Nonsurgical Retreatment predominated among the participants' choices. Significant differences were detected in (1) Extraction for postgraduate students (P = .008) and endodontists (P = .001), (2) Surgical Retreatment for general practitioners (P = .002), postgraduate students (P = .002), and endodontists (P = .001), and (3) Wait and See for postgraduate students (P = .023).

Differences in specialty training and experience strongly influence endodontic decision making. Endodontists showed the most consistent agreement among the groups.