Evaluating General Practitioner attitudes towards Screening, Risk Assessment, and Diagnosis of Periodontal Disease and Tooth Wear in the UK and Ecuador

Background: To investigate general practitioners' habits and attitudes with screening, risk assessment, and diagnosis of periodontal disease and tooth wear amongst adult dental patients attending examination appointments in the UK and Ecuador. Methods: Three primary recruiters, all final year post-graduate students enrolled on the MSc in Aesthetic Dentistry at King’s College London (one based in Ecuador, two in the UK) distributed a piloted, paper-based, 14-statement questionnaire via secondary recruiters to general dentists. The latter participants were based at local dental practices or attending post-graduate courses. The secondary recruiters circulated and collected the questionnaire from the participants on the same day of distribution. Responses were supplied in an anonymised manner, and returned to the primary recruiters, either physically or by the scanning of the responses. Data was analysed using descriptive statistics, Chi-squared, and Fisher’s exact tests in Stata, Version 12, with significance at p<0.05. Results: 445 questionnaires distributed; 361 completed (UK, 261 and Ecuador 100; response rate: 81.1%). Overall, higher levels of agreement were reported with performing periodontal disease risk assessments, probing, and recording diagnoses (≥81.0%). 98.5% of UK participants used the Basic Periodontal Examination (BPE) for routine periodontal screening. Routine tooth wear risk assessments for adult patients were performed by ≥81.9% of the sample and 74% of UK-participants conducted routine clinical tooth wear assessments and recorded diagnoses. Overall, only 21.6% regularly used an index for scoring and recording tooth wear; Basic Erosive Wear Examination (BEWE) was most popular. Satisfaction with undergraduate training was over 3 times greater for periodontal disease than for tooth wear. Conclusions: For the overall sample, differences were observed between the assessment and diagnosis of periodontal disease and tooth wear respectively. Based on the results of this study, the need for consensus with tooth wear assessment and diagnosis, as well as with improved satisfaction with undergraduate education are supported.