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Amalgam Phase-Down Part 2: UK-Based Knowledge, Opinions, and Confidence in the Alternatives

INTRODUCTION: Amalgam use has recently been phased down, and the potential for a phase-out is being investigated. OBJECTIVES: The study aimed to identify knowledge of the phase-down and opinions of a potential phase-out of amalgam by UK primary care clinicians and assess their confidence in using di...

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Autores principales: Bailey, O., Vernazza, C.R., Stone, S., Ternent, L., Roche, A.-G., Lynch, C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8674793/
https://www.ncbi.nlm.nih.gov/pubmed/33300424
http://dx.doi.org/10.1177/2380084420954766
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author Bailey, O.
Vernazza, C.R.
Stone, S.
Ternent, L.
Roche, A.-G.
Lynch, C.
author_facet Bailey, O.
Vernazza, C.R.
Stone, S.
Ternent, L.
Roche, A.-G.
Lynch, C.
author_sort Bailey, O.
collection PubMed
description INTRODUCTION: Amalgam use has recently been phased down, and the potential for a phase-out is being investigated. OBJECTIVES: The study aimed to identify knowledge of the phase-down and opinions of a potential phase-out of amalgam by UK primary care clinicians and assess their confidence in using different materials in different situations. METHODS: An anonymized, prepiloted cross-sectional e-survey was used to assess primary care clinicians’ knowledge and opinions of the amalgam phase-down and potential phase-out and their confidence in using amalgam and the alternatives in different situations. In total, 11,902 invitations were distributed through British dentist and therapist associations. Prior hypotheses were tested alongside descriptive statistics. RESULTS: Response rate was 13% (n = 1,513). Knowledge of the amalgam phase-down was low, with just 3% clinicians correctly identifying all patient groups in whom amalgam use should be avoided in the United Kingdom. Postgraduate education on posterior composite placement was high (88%), but a large majority had personal and patient-centered concerns over the suitability of the alternatives and lacked confidence when placing composite in comparison to amalgam in difficult situations (P < 0.0001). Logistic regressions revealed that the best predictors of high confidence in placing mesio-occluso-distal composites and composites in difficult situations were being a private general dentist or being primarily a composite user. CONCLUSION: Primary care clinicians have major personal and patient-centered concerns regarding the amalgam phase-down (of which they have limited knowledge) and potential phase-out. Many lack confidence in using the alternative, composite, to restore posterior teeth in difficult situations, whereas confidence in using amalgam in similar situations is high. Effective education of clinicians and understanding patients’ needs, alongside policy changes, are required to enable a successful amalgam phase-down and potential phase-out. KNOWLEDGE TRANSFER STATEMENT: This study shows that UK primary care clinicians are worried about the phase-down of amalgam for themselves and their patients. Many lack confidence in the alternative, composite, when used in difficult situations, which is in stark contrast to amalgam. Knowledge of the phase-down is limited. There is a need for more effective education of clinicians, an understanding of patients’ values, and policy changes to ensure the success of the phase-down and potential phase-out of amalgam.
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spelling pubmed-86747932021-12-17 Amalgam Phase-Down Part 2: UK-Based Knowledge, Opinions, and Confidence in the Alternatives Bailey, O. Vernazza, C.R. Stone, S. Ternent, L. Roche, A.-G. Lynch, C. JDR Clin Trans Res Original Reports INTRODUCTION: Amalgam use has recently been phased down, and the potential for a phase-out is being investigated. OBJECTIVES: The study aimed to identify knowledge of the phase-down and opinions of a potential phase-out of amalgam by UK primary care clinicians and assess their confidence in using different materials in different situations. METHODS: An anonymized, prepiloted cross-sectional e-survey was used to assess primary care clinicians’ knowledge and opinions of the amalgam phase-down and potential phase-out and their confidence in using amalgam and the alternatives in different situations. In total, 11,902 invitations were distributed through British dentist and therapist associations. Prior hypotheses were tested alongside descriptive statistics. RESULTS: Response rate was 13% (n = 1,513). Knowledge of the amalgam phase-down was low, with just 3% clinicians correctly identifying all patient groups in whom amalgam use should be avoided in the United Kingdom. Postgraduate education on posterior composite placement was high (88%), but a large majority had personal and patient-centered concerns over the suitability of the alternatives and lacked confidence when placing composite in comparison to amalgam in difficult situations (P < 0.0001). Logistic regressions revealed that the best predictors of high confidence in placing mesio-occluso-distal composites and composites in difficult situations were being a private general dentist or being primarily a composite user. CONCLUSION: Primary care clinicians have major personal and patient-centered concerns regarding the amalgam phase-down (of which they have limited knowledge) and potential phase-out. Many lack confidence in using the alternative, composite, to restore posterior teeth in difficult situations, whereas confidence in using amalgam in similar situations is high. Effective education of clinicians and understanding patients’ needs, alongside policy changes, are required to enable a successful amalgam phase-down and potential phase-out. KNOWLEDGE TRANSFER STATEMENT: This study shows that UK primary care clinicians are worried about the phase-down of amalgam for themselves and their patients. Many lack confidence in the alternative, composite, when used in difficult situations, which is in stark contrast to amalgam. Knowledge of the phase-down is limited. There is a need for more effective education of clinicians, an understanding of patients’ values, and policy changes to ensure the success of the phase-down and potential phase-out of amalgam. SAGE Publications 2020-12-10 2022-01 /pmc/articles/PMC8674793/ /pubmed/33300424 http://dx.doi.org/10.1177/2380084420954766 Text en © International & American Associations for Dental Research 2020 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Reports
Bailey, O.
Vernazza, C.R.
Stone, S.
Ternent, L.
Roche, A.-G.
Lynch, C.
Amalgam Phase-Down Part 2: UK-Based Knowledge, Opinions, and Confidence in the Alternatives
title Amalgam Phase-Down Part 2: UK-Based Knowledge, Opinions, and Confidence in the Alternatives
title_full Amalgam Phase-Down Part 2: UK-Based Knowledge, Opinions, and Confidence in the Alternatives
title_fullStr Amalgam Phase-Down Part 2: UK-Based Knowledge, Opinions, and Confidence in the Alternatives
title_full_unstemmed Amalgam Phase-Down Part 2: UK-Based Knowledge, Opinions, and Confidence in the Alternatives
title_short Amalgam Phase-Down Part 2: UK-Based Knowledge, Opinions, and Confidence in the Alternatives
title_sort amalgam phase-down part 2: uk-based knowledge, opinions, and confidence in the alternatives
topic Original Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8674793/
https://www.ncbi.nlm.nih.gov/pubmed/33300424
http://dx.doi.org/10.1177/2380084420954766
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