Risk Judgment by General Dental practitioners: Rational but Uninformed

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.