Relative importance of eight oral conditions for a fit dentition according to Dutch general practitioners

Almost 5 million Dutch National Health Service members visit the dentist half-yearly in order to keep their so-called "dental fitness certificate" valid. The methods of paired comparisons and direct ranking were used to study the relative importance of eight oral conditions for a fit dentition: plaque, calculus, gingivitis, a pocket, a cavity, a root/radicle, a fistula and an extraction diastema. The assessments were made by a sample of Dutch general practitioners under contract to the National Health Service (n = 49). Each dentist was consistent in his comparative pairwise choices. Although agreement between the dentists was statistically significant, the low coefficient indicated individual differences between the dentists. The average rank orders of the eight oral conditions obtained from the dentists as a group by means of the two methods were highly comparable. To obtain dental fitness the dentists judged the treatment of a fistula and gingivitis more important than the treatment of plaque, calculus and cavities, and least important, the three conditions: root/radicles, pockets and extraction diastema. This average rank order indicates a shift in the concept of "dentally fit" as stated in the requirements, dating back to 1960, for granting a dental fitness certificate.