Publikationer från Malmö universitet
Ändra sökning
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
What findings do clinicians use to diagnose chronic periodontitis?
Malmö högskola, Odontologiska fakulteten (OD).
Maxillofacial Unit, Halmstad Hospital, Halmstad, Sweden.
Malmö högskola, Odontologiska fakulteten (OD).
2008 (Engelska)Ingår i: Swedish Dental Journal, ISSN 0347-9994, Vol. 32, nr 3, s. 115-123Artikel i tidskrift (Refereegranskat) Published
Abstract [sv]

Kronisk sjukdom har ett eller flera av följande karakteristika: sjukdomen är varaktig, lämnar kvarvarande invaliditet, orsakar irreversibla patologiska förändringar och fordrar återkommande stöd i form av någon slags intervention eller instruktion. Detta innebär att diagnosen kronisk parodontit med stor sannolikhet medför personella och ekonomiska insatser från patient och tandvård. Majoriteten av alla patienter med parodontit har kronisk parodontit. Vilka fynd som används för att diagnostisera sjukdomen kan vara av central betydelse för val av behandling. Tidigare forskningsresultat visar att det finns stora variationer inom hälso- och sjukvård avseende vilka fynd som används för att ställa diagnos och hur man omhändertar patienter med likartade diagnoser/symptom. Målet med studien var att undersöka vilka fynd olika kategorier av kliniker använder för att ställa diagnosen kronisk parodontit och om det finns skillnader mellan de olika kategorierna. En enkät distribuerades som innehöll frågan: "Vilka fynd eller kombinationer av fynd använder du för att ställa diagnosen kronisk parodontit?". De undersökta kategorierna av kliniker utgjordes av sista terminens tandläkarstuderande och tandhygieniststuderande, kliniska lärare på Tandvårdshögskolan i Malmö och VFU (verksamhetsförlagd utbildning) -handledare i folktandvården dvs. tandläkare som är ansvariga för tandläkarstuderande när de fullgör sin obligatoriska tjänstgöring i folktandvården. Sjuttiosex kliniker, som representerade de olika kategorierna, angav tjugofem olika fynd för att ställa diagnosen kronisk parodontit. De fynd som angavs mest frekvent av samtliga kategorier var blödning, fördjupad tandköttsficka och förlust av marginal benvävnad. Tandhygieniststuderande angav signifikant fler fynd (P<0.05) än övriga kategorier och var mer benägna att använda irrelevanta fynd, dvs. fynd som inte per definition beskriver själva sjukdomen, t.ex. tandsten, plack och rökning, jämfört med övriga kategorier (P<0.05). Stor variation inom en och samma kategori av kliniker sågs också avseende vilka fynd som användes för att ställa diagnosen kronisk parodontit, dvs. om man angav fynd som påvisar inflammation i tandens stödjevävnad, förlust av tandens stödjevävnad eller om fynden var irrelevanta. Anmärkningsvärt var att de flesta deltagarna använde fynden solitärt, dvs. de angav antingen ett fynd som påvisade inflammation i tandens stödjevävnad eller ett fynd som påvisade förlust av tandens stödjevävnad eller ett fynd som var irrelevant. Endast 12 av de 76 deltagarna angav att de kombinerade fynden för att ställa diagnosen, dvs. en kombination av fynd som beskrev både förlust och inflammation av tandens stödjevävnad. Variationerna i vilka fynd man använde för att ställa diagnosen kronisk parodontit medför kanske att patienter med samma diagnos och sjukdomsbild får olika behandling av olika kliniker, om fyndet som användes för att ställa diagnos också ligger till grund för behandlingen. Detta kan i sin tur leda till icke kostnadseffektiv behandling. Vi avser att belysa detta i framtida studier.

Abstract [en]

The prevalence of chronic periodontitis is around 40% in the adult population and most patients visiting a dental clinic experience an intervention related to this disease, either as prophylaxis, e.g. disease information, oral hygiene instruction and polishing, or as treatment of the disease, per se. Hence, chronic periodontitis is a diagnosis that initiates time and costs consuming interventions. The findings clinicians use to diagnose chronic periodontitis are probably also the base for their choice of treatment. The aim of this study was to examine: - What findings dental students, dental hygienist students, dental teachers, and supervisors in Public Dental Health use to diagnose patients with chronic periodontitis. - If different categories of clinicians use different findings to diagnose chronic periodontitis. A questionnaire was distributed. Seventy-six clinicians representing the four categories answered the question: "What findings, or combinations of findings, do you use when you diagnose chronic periodontitis?" Twenty-five different findings were identified as findings the clinicians use when they diagnosed chronic periodontitis. The most frequently reported findings were bleeding, deepened pockets and loss of marginal bone tissue. Variations between different categories of clinicians were identified. For example, dental hygienist students used more findings (P<0.05), and were also more inclined to use irrelevant findings like calculus, plaque, smoking, compared to the other categories of clinicians (P<0.05). The majority of clinicians used only one finding at a time to diagnose chronic periodontitis, and more seldom combined findings. Only 12 out of 76 clinicians used a finding that provided soft tissue inflammation, e.g. bleeding, in combination with a finding that provided loss of supporting tissue, e.g. marginal bone loss. Few clinicians commented that there should be a progressive loss of supporting tissue over time. Further research is needed to investigate if these variations in findings used to diagnose chronic periodontitis indicate variations in treatment of these patients.

Ort, förlag, år, upplaga, sidor
Swedish Dental Association , 2008. Vol. 32, nr 3, s. 115-123
Nyckelord [en]
periodontitis, diagnosis, chronic disease, decision-making
Nationell ämneskategori
Odontologi
Identifikatorer
URN: urn:nbn:se:mau:diva-6111ISI: 000260200100002PubMedID: 18973082Scopus ID: 2-s2.0-53949109599Lokalt ID: 6887OAI: oai:DiVA.org:mau-6111DiVA, id: diva2:1402999
Tillgänglig från: 2020-02-28 Skapad: 2020-02-28 Senast uppdaterad: 2024-05-31Bibliografiskt granskad
Ingår i avhandling
1. Self-directed learning, teamwork, holistic view and oral health
Öppna denna publikation i ny flik eller fönster >>Self-directed learning, teamwork, holistic view and oral health
2014 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

The dental program at the Malmö dental school, the so called Malmö-model, is guided by four linked principles: self-directed learning, teamwork, a holistic view of patient care, and oral health (Fig.1). Figure 1. The four guiding principles of problem based learning at TVH, Malmö.Self-assessment ability is a critical competence for healthcare professionals, necessary for the successful adaptation to the modern life-long learning environment. Educational research seems to point out two critical factors for the development of such skills, continuous practice of self-assessment (1) and constructive feedback (2). The first study (3) presented in this publication assessed students’ self-assessment ability by means of the Interactive Examination in a cohort of senior dental students, who had gone through an identical assessment procedure during their second year of studies (4). The results indicated that self-assessment ability was not directly relevant to subject knowledge. Upon graduation, there were a number of students (10%) with significant self-assessment difficulties. Early detection of students with weak self-assessment abilities appears possible to achieve. The aim of the second study, concerning teamwork and holistic view (5), was to investigate if highlighting teamwork between dental and dental hygienist students could improve the students’ holistic view on patients, as well as their knowledge of, and insight into, each other's future professions. Thus, this project showed that by initiating teamwork between dental and dental hygienist students, it was possible to increase students’ knowledge on dental hygienists competence, develop students’ perceived holistic view on patients, and prepare students for teamwork. The third study explored findings clinicians use when diagnosing chronic periodontitis. A questionnaire was distributed to students, dental teachers and clinical supervisors in the Public Dental Services. Within all categories of clinicians, the majority of the clinicians used deepened pocket, bone loss on x-rays, and bleeding. There were differences in the use of findings between the categories of clinicians. None of the supervisors used attachment loss as a finding, while 13% to 27% of the other categories of clinicians used this finding. A higher frequency of dental hygienist students used plaque, calculus and pus, compared to the other categories.Dental hygienist students used more findings as compared to the other categories of clinicians. Fifty-eight of the 76 clinicians used each finding solitarily, i.e. one at a time, and not in combination to diagnose chronic periodontitis. However, about a third of the dental students and the supervisors only used findings either from the soft tissue inflammation subgroup or the loss of supporting tissue subgroup. With the exception of the dental teachers, the majority of clinicians within each category used irrelevant findings. The third study (6) gave valuable information when designing the fourth study (7). The In the fourth study, a questionnaire was distributed to 2,440 professional clinicians, i.e. dentists and dental hygienists in public and private activity, and dental students at the Dental school in Malmö. The results showed that two groups, representing dentists and dental hygienists delivering basic periodontal care in Sweden, were to a significant degree not sharing the knowledge basis for diagnosis and treatment planning. This may result in a less optimal utilization of resources in Swedish dentistry. The delivery of basic periodontal care was not in line with the severity of disease and too much attention was paid to the needs of relatively healthy persons. To change this pattern, the incentives in, and structure of, the national assurance system need to be adapted in order to stimulate a better inter-collegial cooperation between dentists and dental hygienists in basic periodontal care.

Ort, förlag, år, upplaga, sidor
Malmö University, Faculty of Odontology, 2014. s. 65
Serie
Swedish Dental Journal : Supplement, ISSN 0348-6672 ; 235
Nyckelord
Livslångt lärande, Munhälsa, Tandläkarutbildning, Problembaserat lärande, Oral health, Education, Dental, Diagnosis, Patient Care Team
Nationell ämneskategori
Odontologi
Identifikatorer
urn:nbn:se:mau:diva-7726 (URN)17710 (Lokalt ID)9789171046055 (ISBN)9789171046062 (ISBN)17710 (Arkivnummer)17710 (OAI)
Anmärkning

Paper IV is not included in the fulltext online.

Paper IV  published in dissertation as manuscript with title "A comparison of proposals for diagnosis and treatment of periodontal conditions by dentists, dental hygienists and undergraduate students: An analysis based on the recommendations from the Swedish National Guidelines"

Tillgänglig från: 2020-02-28 Skapad: 2020-02-28 Senast uppdaterad: 2024-03-08Bibliografiskt granskad

Open Access i DiVA

Fulltext saknas i DiVA

PubMedScopus

Person

Leisnert, LeifHallström, HadarKnutsson, Kerstin

Sök vidare i DiVA

Av författaren/redaktören
Leisnert, LeifHallström, HadarKnutsson, Kerstin
Av organisationen
Odontologiska fakulteten (OD)
I samma tidskrift
Swedish Dental Journal
Odontologi

Sök vidare utanför DiVA

GoogleGoogle Scholar

pubmed
urn-nbn

Altmetricpoäng

pubmed
urn-nbn
Totalt: 48 träffar
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf