Background: Any clinical decision made has an effect on both the patient and the outcome of their treatment. There is little known about how dentists weight up factors before they make a clinical decision. Aim and Objective: A pilot qualitative investigation of the factors influencing dentists allocating children needing operative treatment to local anaesthetics only, Local anaesthetic with a form of sedation or general anaesthetic. Method: 14 dentist invited to take part in an in-depth interview with a trained interviewer. Dentists were asked about their dental training background, how they assessed children, treatment planning, dental anxiety, parental influence and how they decide by which pharmacological behaviour management technique the child should be treated. Interviews were recorded, transcribed then themes developed using a framework analysis approach. Result: Dentists were found to be the main influencing individuals in clinical decision making. Parents and young children in particular having a limited input. They are also happy with current methods and have a poor opinion about anxiety scales. Pharmacological behaviour techniques are selected mainly based on the magnitude and type of treatment to be conducted. Dentists tend to seek alternative behaviour techniques or change their initial treatment plan only if parents disagreed with them; especially if general anaesthesia was considered. An audit of a 1000 patient file treated on the department also found that treatment to be conducted is the main influencing factor; especially the number of teeth to be extracted. Dentists were found to be poor in predicting patient whom would benefit from treatment on the dental chair, and were better in identifying patients who needed general anaesthesia. Additional clinical decision making influential factors were identified; history of pain and swelling, child’s behaviour, parental opinion and previous dental experience. Conclusion: In conclusion, clinical decision making in this sample appeared to be subjective. A more systematic approach to behaviour and anxiety assessment is required.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:634653 |
| Date | January 2014 |
| Creators | Alshammasi, H. |
| Publisher | University College London (University of London) |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://discovery.ucl.ac.uk/1456290/ |
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