Dentists' judgment strategies on prophylactic removal of mandibular third molars

The number of molars selected for prophylactic removal varies widely among general dental practitioners and oral surgeons. To understand the basis for such variations, we investigated two hypotheses: (1) Individual judgment s trategies will differ concerning the use of cues (items of information), an d (2) few dentists will integrate the cues according to evidence in the lit erature. To analyze 30 general dental practitioners' (GDPs) and 10 oral sur geons' use of cues in the judgment preceding the treatment decision, we use d the Brunwik's lens as a conceptual model. The cues were the patient's age , and the angular position and the degree of impaction of the molar. The cl inical situation was simulated by written case descriptions. The proportion of variation explained by the cues and their combinations (total model) va ried between 61% and 100% and between 4% and 76% as main effects. Two GDPs and one oral surgeon integrated the cues additively, i.e., any of the cues is independent of the other cues in the judgment. In general, the dentists integrated the cues interactively, i.e., the impact of one cue depends on t he levels of some other cues. Even though most variations in judgments were accounted for by the cues, the dentists did not integrate the cues accordi ng to evidence in the literature and lacked insight into their decision-mak ing thought processes.