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How confident are general dental practitioners in their decision to administer antibiotic prophylaxis? A questionnaire study.

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Oral Health Assessment by Lay Personnel for Older Adults
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Risk Judgment by General Dental practitioners: Rational but Uninformed.

Eva Ellervall1, Berndt Brehmer2, Kerstin Knutsson3

  • 1Health Evidence Network, World Health Organization Regional Office for Europe, Copenhagen, Denmark.

Biomedical Informatics Insights
|July 27, 2016
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Dentists often overestimate the risk of complications when prescribing antibiotics for dental procedures. While their decisions align with their risk assessments, these judgments are frequently inaccurate and require evidence-based strategies for improvement.

Keywords:
antibiotic prophylaxisdecision makingjudgmentrisk assessment

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Area of Science:

  • Dental medicine
  • Infectious disease prevention
  • Clinical risk assessment

Background:

  • Dentists' decisions on antibiotic prophylaxis involve risk assessment, yet adherence to guidelines is often low.
  • Previous studies indicate challenges in the rational use of antibiotics in dental practice.

Purpose of the Study:

  • To evaluate how general dental practitioners (GDPs) assess the risk of complications in patients with specific medical conditions when not administering antibiotic prophylaxis.
  • Investigate the relationship between GDPs' risk assessments and their antibiotic prescribing behavior.

Main Methods:

  • A postal questionnaire combined with telephone interviews was used.
  • Risk assessments were quantified using visual analogue scales (VAS), ranging from 0 (insignificant risk) to 100 (very significant risk).

Main Results:

  • The response rate was 51%. GDPs who administered antibiotics reported significantly higher mean risk assessments (54) compared to those who did not (14).
  • Risk assessments were higher for conditions listed in guidelines than for those not listed.
  • Risk assessments were higher for tooth extraction compared to scaling or root canal treatment, despite similar recommended risk levels.

Conclusions:

  • GDPs' risk assessments were deemed rational but based on incomplete information, leading to overestimations.
  • Antibiotic administration by GDPs was consistent with their risk assessments, though these assessments were often inflated.
  • Behavioral change requires motivated clinicians and evidence-based implementation strategies to address inaccurate risk judgments.