How Do General Dentists and Orthodontists Determine Where to Refer Patients Requiring Oral and Maxillofacial Surgical Procedures?

Schlieve, Thomas; Funderburk, J.; Flick, William G.; Miloro, Michael; Kolokythas, Antonia

doi:10.1016/j.joms.2014.08.004

Cited by 8 publications

(7 citation statements)

References 8 publications

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“…We also found that dentists who reported the presence of specialists in close proximity perceived medium/large competitive pressure from them. This is corroborated by the findings of previous studies [ 18 , 19 ], which suggest a lower rate of referrals from practices closer to a specialist. Another possible explanation might be that practicing in the same area as specialists can burden general dentists in terms of maintaining patient volume, ultimately adding to the competitive pressure they perceive from specialists [ 18 ].…”

Section: Discussionsupporting

confidence: 88%

“…1 ) that, through a literature review, identified different factors (environmental, patient-, dentist-, and practice-related) that may affect, or are hypothesized to affect, the general dentist–specialist relationship [ 21 ]. In the absence of studies that explored this interprofessional relationship directly, we included factors shown in the literature to influence dentists’ referrals and clinical decisions [ 14 , 15 , 17 – 19 ]. The survey collected dentists’ socio-demographic information, professional characteristics, and their perceptions of confidence in, and competition with, specialists.…”

Section: Methodsmentioning

confidence: 99%

“…While previous studies [ 14 , 15 , 17 – 19 ] have explored various clinical and non-clinical factors that influence referrals and other clinical decisions, the dynamics of what influences the general dentist–specialist relationship remains unexplored. The aim of this study is thus to explore practitioner- and practice-related factors that may be associated with general dentists’ perceptions of their relationship with dental specialists in Canada.…”

Section: Introductionmentioning

confidence: 99%

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What non-clinical factors influence the general dentist–specialist relationship in Canada?

et al. 2021

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Background The general dentist–specialist relationship is important for effective patient care and the professional environment. This study explores the non-clinical factors that may influence the general dentist–specialist relationship in Canada. Methods A cross-sectional web-based survey of a sample of general dentists across Canada was conducted (N ≈ 11,300). The survey collected information on practitioner (e.g., age, gender, years of practice) and practice (e.g., location, ownership) factors. Two outcomes were assessed: not perceiving specialists as completely collegial and perceiving competitive pressure from specialists. Binary and multivariable logistic regression analysis was conducted. Results A total of 1328 general dentists responded, yielding a response rate of 11.7%. The strongest associations for perceiving specialists as not completely collegial include being a practice owner (OR = 2.15, 95% CI 1.23, 3.74), working in two or more practices (OR = 1.69, 95% CI 1.07, 2.65), practicing in a small population center (OR = 0.46, 95% CI 0.22, 0.94), and contributing equally to the household income (OR = 0.47, 95% CI 0.26, 0.84). The strongest associations with perceiving medium/large competitive pressure from specialists include having a general practice residency or advanced education in general dentistry (OR = 2.00, 95% CI 1.17, 3.41) and having specialists in close proximity to the practice (OR = 2.52, 95% CI 1.12, 5.69). Conclusion Practitioner and practice factors, mostly related to business and dental care market dynamics, are associated with the potential for strained relationships between general dentists and specialists in Canada. This study points to the need for dental professional organizations to openly discuss the current state of the dental care market, as it has important implications for the profession.

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Section: Discussionsupporting

confidence: 88%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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What non-clinical factors influence the general dentist–specialist relationship in Canada?

et al. 2021

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“…Other centers managing a specific subgroup of challenging patients with high-risk conditions should also publish their particular approaches and OGS-related outcomes. The published results will provide the basis to expand the criteria for OGS in the future and will support the spread of this possibility of treatment to referral health care providers (general dentists and orthodontists) [54], anesthesiologists, ENT, head and neck surgeons, plastic surgeons, maxillofacial surgeons, oral surgeons, and patients and their parents.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Orthognathic Surgery Outcomes Between Patients With and Without Underlying High-Risk Conditions: A Multidisciplinary Team-Based Approach and Practical Guidelines

Chou

Denadai

Chen

et al. 2019

JCM

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Orthognathic surgery (OGS) has been successfully adopted for managing a wide spectrum of skeletofacial deformities, but patients with underlying conditions have not been treated using OGS because of the relatively high risk of surgical anesthetic procedure-related complications. This study compared the OGS outcomes of patients with and without underlying high-risk conditions, which were managed using a comprehensive, multidisciplinary team-based OGS approach with condition-specific practical perioperative care guidelines. Data of surgical anesthetic outcomes (intraoperative blood loss, operative duration, need for prolonged intubation, reintubation, admission to an intensive care unit, length of hospital stay, and complications), facial esthetic outcomes (professional panel assessment), and patient-reported outcomes (FACE-Q social function, psychological well-being, and satisfaction with decision scales) of consecutive patients with underlying high-risk conditions (n = 30) treated between 2004 and 2017 were retrospectively collected. Patients without these underlying conditions (n = 30) treated during the same period were randomly selected for comparison. FACE-Q reports of 50 ethnicity-, sex-, and age-matched healthy individuals were obtained. The OGS-treated patients with and without underlying high-risk conditions differed significantly in their American Society of Anesthesiologists Physical Status (ASA-PS) classification (p < 0.05), Charlson comorbidity scores, and Elixhauser comorbidity scores. The two groups presented similar outcomes (all p > 0.05) for all assessed outcome parameters, except for intraoperative blood loss (p < 0.001; 974.3 ± 592.7 mL vs. 657.6 ± 355.0 mL). Comparisons with healthy individuals revealed no significant differences (p > 0.05). The patients with underlying high-risk conditions treated using a multidisciplinary team-based OGS approach and the patients without the conditions had similar OGS-related outcomes.

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“…Whilst studies 9 , 10 , 11 have identified a number of factors that influence general dentists’ referrals and clinical treatment decisions, there is a scarcity of literature about what constitutes a positive relationship between general dentists and specialists. Apart from communication and professional expertise, other factors that may assist in ensuring a positive interprofessional relationship between general dentists and specialists include the practitioners’ demeanor, willingness to communicate, and mutual respect.…”

Section: Introductionmentioning

confidence: 99%

General Dentists’ Perceptions About Their Relationship With Specialists

Kaur

Singhal

Glogauer

et al. 2022

International Dental Journal

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How Do General Dentists and Orthodontists Determine Where to Refer Patients Requiring Oral and Maxillofacial Surgical Procedures?

Cited by 8 publications

References 8 publications

What non-clinical factors influence the general dentist–specialist relationship in Canada?

What non-clinical factors influence the general dentist–specialist relationship in Canada?

Comparison of Orthognathic Surgery Outcomes Between Patients With and Without Underlying High-Risk Conditions: A Multidisciplinary Team-Based Approach and Practical Guidelines

General Dentists’ Perceptions About Their Relationship With Specialists

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