A questionnaire instrument to assess clinical decision-making in prosthodontics among general practitioners

There are great variations in dentists' choice of treatment. The aim of this study was to evaluate a Patient Paper Case (PPC) technique to investigate such variation, adjusted for prosthodontics. The questionnaire was sent to all 131 general practitioners (GP) in the Public Dental Service in Orebro County and to all 100 GPs in private practice in Skaraborg County, Sweden, with 81% responding. There were three PPC questions, concerning 1) crown therapy or amalgam/composite filling, 2) fixed or removable partial denture, 3) fixed partial denture or single implant restoration. Respondents were asked to assess 13 or 14 items concerning the patient, dental conditions, and own skills. There was great variation in responses. In factor analysis four factors were found to capture between 54% and 60% of the variance of the items. They were interpreted as a time factor, a patient subjective factor, a clinical factor, and finally, for the PPC 1 and 2, a general health factor. The Swedish insurance regulations of single implant therapy, mandatory caries/filling-free, and vital adjacent teeth were reflected in the factor solution of PPC 3. It is concluded that the PPC method is feasible and useful in studies of clinical decision-making in prosthodontics.