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“It′s good enough”: Swedish general dental practitioners on reasons for accepting sub-standard root filling quality

Journal article
Authors Lisbeth Dahlström
Oskar Lindwall
Hans Rystedt
Claes Reit
Published in International Endodontic Journal
ISSN 0143-2885
Publication year 2017
Published at Institute of Odontology
The Linnaeus Centre for Research on Learning, Interaction, and Mediated Communication in Contemporary Society (LinCS)
Institute of Odontology, Section 1
Department of Education, Communication and Learning
Language en
Subject categories Other Medical Sciences, Educational Sciences

Abstract

Aim The concept of “good enough” is central and necessary in the assessment of root filling quality. The aim was to explore the concept by analysing reasons and arguments for the acceptance or rejection of substandard root filling quality as reported by GDPs in Sweden. Methodology The study was designed as a qualitative and exploratory study based on seven videotaped focus group interviews analysed by means of qualitative content analysis. Thirty-three general dental practitioners (GDPs) employed in the Public Dental Health Service in Gothenburg, Sweden, participated (4-6 GDPs/interview). In all nine predetermined questions were followed. Before each focus group, the participants received radiographs of 37 root fillings and were asked to assess the root filling quality. The three cases representing the most divergent assessments served as a basis for the discussion. The cases were presented without clinical information, the dentists would relate to the cases as being just root filled by themselves. Results The radiographs did not provide a sufficient basis for decisions on whether or not to accept the root filling. The present study emphasised that dentists did not primarily look for these arguments in the technical details of the root filling per se but instead they considered selected features of the contextual situation. The GDPs constantly introduced relevant “ad hoc considerations” in order to account for the decisions they made. These contextual considerations were related to aspects of pulpal and periapical disease, risks (e.g. technical complications) or to consumed resources (personal and/or economic). Conclusions It was obvious that the concept of “good enough” does not exist as a general formula ready to be applied in particular situations. Instead, it is necessarily and irremediably tied to contextual properties that emerge from case to case.

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