RELATIONSHIP BETWEEN DENTISTS TREATMENT ATTITUDES AND RESTORATIVE DECISIONS MADE ON THE BASIS OF SIMULATED BITEWING RADIOGRAPHS

The implicit valuations which dentists place on the outcomes of their treatment decisions may be a major contributory factor in dentists' de cisions about when to restore teeth. This study sought to examine the relationship between dentists' treatment attitudes and restorative den tal treatment decision making. A group of 20 dentists were asked to in dicate teeth in need of filling from 15 simulated bitewing radiographs . The dentists graded their level of certainty about their treatment d ecision as ''definite'', ''probable'' or ''possible''. Afterwards, the teeth were sectioned and examined using a microscope in order to dete rmine how far through the tooth the caries had penetrated. The gold st andard treatment criterion was that caries extending into the dentine of the tooth would require restoration. Receiver Operator Characterist ic (ROC) analysis was used to examine the apparent weighting the denti sts were giving to decision errors when planning treatment on the basi s of bitewing radiographs. The dentists also completed a treatment att itudes questionnaire to determine their views about the relative impor tance of false negative and false positive treatment decisions. The re sults suggest that the most appropriate operating point for most of th ese dentists to achieve an outcome which matched their views about the relative importance of the two types of treatment error would be the point at which a filling would ''definitely'' be required.