Abstract
There are common risk factors between general health and oral health. General dental practitioners (GDPs) are seeing increasing numbers of patients presenting with multiple complex medical conditions. In parallel to managing more medically compromised patients, GDPs must provide holistic and technically challenging root canal treatment (RCT) for teeth that are heavily restored. There is little evidence surrounding the health status and preferences of patients undergoing RCT, and the confidence of GDPs in managing them.
This mixed method research engaged both dentists and their patients in a translational approach within a practice-based research network (PBRN). The goals of this study were to examine the self-perceived confidence and competence of New Zealand (NZ) GDPs managing patients for RCT presenting with a range of medical conditions; and their engagement in continuing professional development (CPD) related to endodontics. It also considered the dental experiences and self-perceived general health status of patients requiring RCT.
This study had three parts: A Pilot study, a PBRN survey of GDPs and patients, and Focus Group interviews of GDPs. Quantitative data from the surveys were entered directly into IBM SPSS Statistics Software, and following descriptive analysis, bivariate analysis was used to quantify differences in proportions using Pearson’s Chi square test. Qualitative data was analysed thematically. Focus Group interviews were transcribed verbatim and transferred to NVivo 12 for detailed analysis.
The Pilot study validated the reliability of the survey for use in a larger group. The PBRN survey was implemented in a range of general practices throughout NZ and provided self-reported demographic and health data from patients, as well as perceptions of their oral health and wellbeing. A positive patient experience of RCT was mostly influenced by clear, empathetic communication, and a professional approach by the practitioner.
GDP confidence in providing RCT was strongly related to procedural and patient-related factors rather than specific medical conditions such as those readily controlled with medications including cardiovascular diseases, and diabetes mellitus. The development of CPD related to medical conditions and pharmacology in dentistry was perceived as important.
With the help of both dentists and patients, this study has provided new knowledge, and improves our understanding of patients’ medical status when they present for RCT and how equipped our workforce is to manage endodontic patients. Together this information can inform development of CPD activities and assist NZ GDPs managing patients requiring RCT.