Skip to main content

Advertisement

Log in

Variation in caries treatment proposals among dentists in Norway: the best interest of the child

  • Original Scientific Article
  • Published:
European Archives of Paediatric Dentistry Aims and scope Submit manuscript

An Erratum to this article was published on 28 August 2017

This article has been updated

Abstract

Aim

To explore variation in treatment-related-decisions for severe caries in children among dentists in the Public Dental Service (PDS) in Norway. It was also to evaluate the treatment choices in relation to the best interest of children and a child’s rights to enjoy the highest standard of health care.

Methods

A pre-coded questionnaire was sent electronically to all general dental practitioners (GDPs) working in the PDS in eight counties in Norway (n = 611). The questionnaire included two case scenarios to reflect common dental conditions related to severe caries among 5-year-old children. Paediatric dentists and paediatric students were invited to validate the different treatment options. Frequency distributions and statistical analyses were carried out using Chi square statistics.

Results

The response rate was 65% (n = 391) among the GDPs. A majority of the GDPs preferred a new appointment with behaviour management techniques (BMT) to a child presenting pulpitis and pain. Dentists educated outside the Nordic region would use restraint more often as a treatment alternative when the child was in pain than Nordic-educated dentists (p < 0.05). Dentists with less than 10 years of experience preferred BMT and sedation more often when the child was in pain than their older colleagues, who, however, preferred a waiting approach and no immediate treatment if the child was not in pain (p < 0.05).

Conclusions

Use of BMT and sedation is related to region of education and years of experience. Awareness of ethical principles with the child´s best interest in mind, should receive increased attention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Change history

  • 28 August 2017

    An erratum to this article has been published.

References

  • Arora A, Schwarz E, Blinkhorn AS. Risk factors for early childhood caries in disadvantaged populations. J Invest Clin Dent. 2011;2(4):223–8. doi:10.1111/j.2041-1626.2011.00070.x.

    Article  Google Scholar 

  • Atchison KA, Bibb CA, Lefever KH, et al. Gender differences in career and practice patterns of PGD-trained dentists. J Dent Educ. 2002;66(12):1358–67.

    PubMed  Google Scholar 

  • Brahm CO, Lundgren J, Carlsson SG, et al. Dentists’ skills with fearful patients: education and treatment. Eur J Oral Sci. 2013;121(3 Pt 2):283–91.

    Article  PubMed  Google Scholar 

  • Buchanan AE, Brock DW. Deciding for others the ethics of surrogate decision making. Cambridge: Cambridge University Press; 1990.

    Book  Google Scholar 

  • Curzon M. Behavioural management in paediatric dentistry: historical perspectives. Eur Arch Paediatr Dent. 2008;9(Suppl 1):3–5.

    PubMed  Google Scholar 

  • Dailey YM, Martin MV. Are antibiotics being used appropriately for emergency dental treatment? Br Dent J. 2001;191(7):391–3. doi:10.1038/sj.bdj.4801190a.

    PubMed  Google Scholar 

  • Duggal M. Providing children with the quality dental care they deserve. Community Dent Health. 2006;23(2):66–8.

    PubMed  Google Scholar 

  • Espelid I, Alanen P, Hofmann B. Evidence based dentistry and ethics. Nor Tannlegeforen Tid. 2013;123:28–32.

    Google Scholar 

  • Federation FWD. FDI World Dental Federation. Dental ethics manual. France: FDI World Dental Federation. 2007. http://www.fdiworldental.org/media/70462/1-fdi_dental_ethics_manual_1st_edition_2007.pdf. 2007.

  • Grytten J, Skau I, Holst D. Geographical distribution of dentists (Geographical distribution of dentists whitin Norway). Nor Tannlegefor Tidende. 2002;112:172–7.

    Google Scholar 

  • Hilgert LA, Frencken JE, de Amorim RG, et al. A study on the survival of primary molars with intact and with defective restorations. Int J Pediatr Dent. 2016;26(5):383–90. doi:10.1111/ipd.12215.

    Article  Google Scholar 

  • Hill KB, Hainsworth JM, Burke FJ, et al. Evaluation of dentists’ perceived needs regarding treatment of the anxious patient. Br Dent J. 2008;204(8):E13. doi:10.1038/sj.bdj.2008.318 discussion 442-3.

    Article  PubMed  Google Scholar 

  • Hugoson A, Falk M, Johansson S. Consensus conference on caries in the primary dentition and its clinical management. Jönköping: Gothia; 2001.

    Google Scholar 

  • Klingberg G, Broberg AG. Dental fear/anxiety and dental behaviour management problems in children and adolescents: a review of prevalence and concomitant psychological factors. Int J Pediatr Dent. 2007;17(6):391–406. doi:10.1111/j.1365-263X.2007.00872.x.

    Article  Google Scholar 

  • Krauss BS, Calligaris L, Green SM, et al. Current concepts in management of pain in children in the emergency department. Lancet (London, England). 2016;387(10013):83–92. doi:10.1016/s0140-6736(14)61686-x.

    Article  Google Scholar 

  • Krekmanova L, Bergius M, Robertson A, et al. Everyday- and dental-pain experiences in healthy Swedish 8–19 year olds: an epidemiological study. Int J Pediatr Dent. 2009;19(6):438–47. doi:10.1111/j.1365-263X.2009.01016.x.

    Article  Google Scholar 

  • Lee GH, McGrath C, Yiu CK. The care of the primary dentition by general dental practitioners and paediatric dentists. Int Dent J. 2013;63(5):273–80. doi:10.1111/idj.12055.

    PubMed  Google Scholar 

  • Palmer NO, Martin MV, Pealing R, et al. Paediatric antibiotic prescribing by general dental practitioners in England. Int J Pediatr Dent. 2001;11(4):242–8.

    Article  Google Scholar 

  • Roberts JF, Curzon ME, Koch G, et al. Review: behaviour management techniques in paediatric dentistry. Eur Arch Paediatr Dent. 2010;11(4):166–74.

    Article  PubMed  Google Scholar 

  • Ronneberg A, Strom K, Skaare AB, et al. Dentists’ self-perceived stress and difficulties when performing restorative treatment in children. Eur Arch Paediatr Dent. 2015;16(4):341–7. doi:10.1007/s40368-014-0168-2.

    Article  PubMed  Google Scholar 

  • Rosenbaum A, Kain ZN, Larsson P, et al. The place of premedication in pediatric practice. Paediatr Anaesth. 2009;19(9):817–28. doi:10.1111/j.1460-9592.2009.03114.x.

    Article  PubMed  Google Scholar 

  • Rossel JH, Lathi S, Strand GV. Ethics in dental education from a Nordic perspective. Nor Tannlegeforen Tid. 2013;123:34–9.

    Google Scholar 

  • Shelley AM, Brunton P, Horner K. Questionnaire surveys of dentists on radiology. Dento Maxillo Facial Radiol. 2012;41(4):267–75. doi:10.1259/dmfr/58627082.

    Article  Google Scholar 

  • Slayton RL. Clinical decision-making for caries management in children: an update. Pediatr Dent. 2015;37(2):106–10.

    PubMed  Google Scholar 

  • Strom K, Ronneberg A, Skaare AB, et al. Dentists’ use of behavioural management techniques and their attitudes towards treating paediatric patients with dental anxiety. Eur Arch Paediatr Dent. 2015;16(4):349–55. doi:10.1007/s40368-014-0169-1.

    Article  PubMed  Google Scholar 

  • Tickle M, Threlfall AG, Pilkington L, et al. Approaches taken to the treatment of young children with carious primary teeth: a national cross-sectional survey of general dental practitioners and paediatric specialists in England. Br Dent J. 2007;203(2):E4. doi:10.1038/bdj.2007.570 discussion 102-3.

    Article  PubMed  Google Scholar 

  • UN Convention on the Rights og the Child [database on the Internet]. United nations human rights office of the high commissioner. 2016. http://www.ohchr.org/en/professionalinterest/pages/crc.aspx. Accessed: June 2016.

  • Vidnes-Kopperud S, Tveit AB, Espelid I. Changes in the treatment concept for approximal caries from 1983 to 2009 in Norway. Caries Res. 2011;45(2):113–20. doi:10.1159/000324810.

    Article  PubMed  Google Scholar 

  • Wilson S, Alcaino EA. Survey on sedation in paediatric dentistry: a global perspective. Int J Pediatr Dent. 2011;21(5):321–32. doi:10.1111/j.1365-263X.2011.01127.x.

    Article  Google Scholar 

  • Wong HM, McGrath CP, King NM, et al. Oral health-related quality of life in Hong Kong preschool children. Caries Res. 2011;45(4):370–6. doi:10.1159/000330231.

    Article  PubMed  Google Scholar 

  • Zitzmann NU, Zemp E, Weiger R, et al. Does a clinician’s sex influence treatment decisions? Int J Prosthodont. 2011;24(6):507–14.

    PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank dentists in the Public Dental Service in the counties of Finnmark, Nordland, Sør-Trøndelag, Møre og Romsdal, Hordaland, Vest-Agder, Hedmark and Oslo for their contributions to the study.

Authors’ contributions

Study concept, design and methodology—AR, ABS, BH, IE. Data collection and data entry—AR. Supervision—IE, ABS. Analysis and interpretation of data—AR, ABS, IE. Writing, review, critique, comments and revision of manuscript—AR, ABS, BH, IE. All authors have read and approved the manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. Rønneberg.

Ethics declarations

Conflict of interest

All authors declare that they have no conflict of interest.

Human participants

This article does not contain any studies with human participants performed by any of the authors.

Additional information

The original version of this article was revised to correct typesetting errors in the Results paragraph of the abstract.

An erratum to this article is available at https://doi.org/10.1007/s40368-017-0300-1.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rønneberg, A., Skaare, A.B., Hofmann, B. et al. Variation in caries treatment proposals among dentists in Norway: the best interest of the child. Eur Arch Paediatr Dent 18, 345–353 (2017). https://doi.org/10.1007/s40368-017-0298-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40368-017-0298-4

Keywords

Navigation