Diagnosis, risk assessment, and treatment decisions for tooth wear in daily practice: a case presentation survey among Belgian dentists.

Abstract

This survey assessed the use of current concepts for tooth wear diagnosis, risk assessment, and treatment decisions in daily practice, and identified factors of significance for treatment decisions. A total of 104 dentists were presented with 10 cases representing varying degrees of tooth wear. The dentists were asked to answer six questions pertaining to the diagnosis, risk assessment, and treatment of each case. A benchmark was established by three experts and the agreement between dentists and the benchmark was calculated. At dentition level, the agreement was moderate for diagnosis (κ=0.55) and risk assessment (κ=0.54). At tooth/surface level, the agreement for clinical and radiographic severity of wear was moderate (κ=0.57) and substantial (κ=0.65), respectively. The agreement for treatment decision was fair (κ=0.35). Multivariate logistic regression analysis showed that treatment decisions for operative treatment were associated with moderate to high case risk (OR=10.1; 95% CI: 5.4-18.9). Belgian dentists performed reasonably well in applying current concepts and strategies for tooth wear diagnosis and risk assessments at dentition level, as well as for assessment of wear severity at tooth/surface level. Improvement is warranted concerning treatment decisions. This survey could be a useful tool for disseminating and improving current knowledge of tooth wear, and for training dentists in daily practice.