Evidence–practice gap for dental sealant application: results from a dental practice-based research network in Japan

Abstract

Purpose The study aims were to: (1) examine dentist practice patterns regarding treatment recommendation of dental sealants; and (2) identify characteristics associated with this recommendation. Methods The study was performed using a cross-sectional questionnaire survey (Clinicaltrials.gov registration number NCT01680848). Participants were Japanese dentists (N=282) recruited from the Dental Practice-based Research Network Japan. Three clinical photographs of the occlusal surface from a mandibular first molar were presented portraying increasing depths of cavitation in a 12-year-old patient with high caries risk. Sealants would be an appropriate treatment in all three scenarios. We asked about the treatment decision for each case. We then performed multiple logistic regression analyses to evaluate associations between the decision to recommend sealants and dentist, patient and practice characteristics. Results Responses were obtained from 189 dentists (67%). In the hypothetical scenarios, dentists' recommendations of sealants for the 12-year old patient varied from 16% to 26% across three hypothesized clinical scenarios. Multiple logistic regression analysis indicated that dentist agreement with the efficacy of assessment for caries risk showed a significant association with the percentages of patients receiving sealants. Conclusions Dentist practice patterns for sealant treatment recommendation change depending on caries severity. The dentists' recommendations of sealants for the 12-year old patient were low for all three selected scenarios, based on indications for sealants in ADA guidelines. Recommending a sealant showed a significant relationship with the dentist having a higher agreement with efficacy of caries risk assessment.

Use of clinical practice guidelines by dentists: findings from the Japanese dental practice‐based research network

“…Gaps between evidence and practice exist [28][29][30][31][32]. Improving this situation may be aided by the wide dissemination of the clinical practice guidelines.…”

Effect of education on physical and occupational therapists’ perceptions of clinical practice guidelines and shared decision making: a randomized controlled trial

“…Based on prior studies, the following were determined as confounding factors: age 10 , 11 ) , gender, academic history 27 ) , years of experience 10 ) , certification as a physio/occupational therapist 12 ) , stage of principal disease according to the hospital where the participants worked (acute, sub-acute, or chronic stages), primary disorder (orthopedic disease, developmental disorder, sports injury, spinal cord injury, post-amputation, psychiatric disorder, neuromuscular disorder, cerebrovascular disease, respiratory disease, cardiovascular disease, or other), weekly duty hours, number of therapists employed at the hospital 10 , 11 ) , number of occupied beds at the hospital 28 ) , number of patients per day 10 , 11 ) , and participation in research activities 12 ) . Data on the aforementioned factors were gathered via a self-administered questionnaire, which was collected in an envelope to ensure anonymity.…”

The Effect of Education on Clinical Practice Guidelines with Shared Decision Making: A Randomized Controlled trial

“…From the preceding study, the following were recruited as confounding factors: age [10,11], sex, academic history [31] , years of experience [10], acquirement of certi ed physio/occupational therapist [12], principal disease stage of the hospital employed (acute phase, recovery phase, chronic phase) [10,11], mainly responsible disorder (orthopedic disease, developmental disorder, sports injury, spinal cord injury, post-amputation, psychiatric disorder, neuromuscular disorder, cerebrovascular disease, respiratory disease, cardiovascular disease, and other) [10,11], weekly duty hours [10,11], number of therapists at the hospital employed [10,11], number of hospital beds at the hospital employed [32], number of responsible patients in a day [10,11], and participation in research activities [12]. The factors above were inquired through a self-administered questionnaire.…”