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Azerbaycan Saytlari

 »  Home  »  Endodontic Articles 10  »  Patients attitudes to rubber dam
Patients attitudes to rubber dam
Results.



Group SP.
Before the target of100 was achieved, seven forms were discarded of which four had not been fully completed by the patient, and three had not had the timings entered on the reverse. Patients ranged from 17 to 84 years in age with 48 females and5 2 males. The distribution of patients’ages and genders is shown in Fig. 2. The types and number of procedures being carried out were

  • (a) endodontics (n = 68),
  • (b) plastic restorations (amalgam and composite) (n = 25), and
  • (c) cementation of etch retained bridges (n = 7).

For this patient group, 6% had found their current experience of RD pleasant, 52% comfortable, whilst 40% felt it was uncomfortable, and 2 % found it painful. When asked whet her they would prefer RD to be used at their next appointment, 43% said yes, 13% said no, with 44% expressing no preference.

Group DP.
Of the 120 forms distributed amongst the dentists’ patients, 106 were returned correctly completed, a response rate of 88%. Of the other 14, six had not been returned, four had not been fully completed by the patient, and four had timing or procedure information missing. Patients ranged from17 to 85 years in age with 64 females and4 2 males. The distribution of patients’ ages and genders is shown in Fig. 3. The types and number of procedures being carried out were

  • (a) endodontics (n = 36),
  • (b) plastic restorations (amalgam and composite) (n = 70).

Amongst this group of patients, 12 (11%) had found RD pleasant, 71 (67%) comfortable, whilst 22 (21%) felt it was uncomfortable, and1 (1%) found it painful. When asked whet her they would prefer RD to be used at their next appointment, 74 (70%) said yes, 4 (4%) said no, with 28 (26%) expressing no preference.
The data was further analyzed to assess whether there were any significant associations between experience or preference and a number of factors.

Figure 2. Distribution of student patients (SP) by age and sex.

Distribution of student patients (SP) by age and sex

Figure 3. Distribution of dentist patients (DP) by age and sex.

Distribution of dentist patients (DP) by age and sex

Age.
Respondents were grouped into three age categories,

  • (a) 40 years and below,
  • (b) 41-60 years and
  • (c) over 60 years.

The numbers of respondents in each category for each patient group were:

Group SP:

  • (a) 25 (10 females, 15 males);
  • (b) 41 (21 females, 20 males);
  • (c) 34 (17 females, 17 males).

Group DP:

  • (a) 40 (25 females, 15 males);
  • (b) 50 (32 females, 18 males);
  • (c) 16 (7 females, 9 males).

There was little difference between the percentage of respondents in each age category who preferred no RD next time within either group (SP: 12-15%; DP: 2-6%). As the age category increased, there was a decrease in the percentage of patients who expressed no preference, and an increase in the percentage of those who would wish RD used next time (Table 1). However, use of w2-test showed no statistically significant association between age group and preference for RD use at the next visit for either patient group.

Table 1. The preference expressed for use of rubber dam at the next visit amongst the different age categories of respondents.

The preference expressed for use of rubber dam at the next visit amongst the different age categories of respondents

Gender.
In both patient groups, half of the male patients expressed no preference for RD use at the next visit whilst the greatest percentage of female patients positively preferred its use. This difference in percentages between the yes and the no preference groups was small (P = 0.37) amongst the student patients but was statistically significant for the dentists’patients (P < 0.01) with a significantly greater percentage of females indicating preference for rubber dam than males. For both male and female respondents, there was a much greater percentage who answered that they would prefer RD compared to those who would not prefer RD use at the next visit (Table 2).

Table 2. The preference expressed for use of rubber dam at the next visit between the sexes in each patient group.

The preference expressed for use of rubber dam at the next visit between the sexes in each patient group

Explanation.
Only four of the student patients and three of the dentist patients did not have the reasons for RD use explained to them, therefore no analysis of this factor which might have modified patient responses was possible. When asked for whose benet respondents felt it (RD) was being used- patient, dentist or both, 76% of SP, and 68% of DP selected- for both, 22% SP, 25% DP- for the patient, and only 4% SP, 8% DP- for the dentist.

Previous Experience.
Twenty-nine student patients and 56 dentist patients had no previous experience of RD use. Of the remainder, in group SP, 28 (39%) found the current experience better, 2 (3%) felt it was worse, and the majority, 41 (58%), judged the experience to have been the same. In group DP, 20 (40%) found the current experience better, 2 (4%) felt it was worse, and the majority, 28 (56%), judged the experience to have been the same.

Current experience.
Patients ranked their current experience of RD as either

  • (I) pleasant (6),
  • (II) comfortable (52),
  • (III) uncomfortable (40) or
  • (IV) painful (2).

To enable comparisons across current experience it was necessary to pool categories I and II into a ‘positive experience’group, and III and IV into a‘negative experience’group. As would be expected, the majority of respondents who had had a positive current experience reported that they would prefer RD to be used next time. The majority of those with a negative current experience expressed no preference, with only 31% of SP and 13% of DP preferring no rubber dam next time. Perhaps surprisingly, over one-third of DP and one-quarter of SP who hadhad a negative current experience still indicated that they would prefer to have RD used at their next visit. The w2-test shows a statistically significant association between preference for RD use next time and current positive experience of RD for both groups (P < 0.001). These trends were also seen both in those who had, and in those who had not had previous experience of RD, with the exception that a greater percentage of those with a negative first-time experience of RD expressed a preference for no RD next time (Table 3).

Table 3. The preference expressed for use of rubber dam at the next visit in relation to the patient's current experience of rubber dam for each patient group.

The preference expressed for use of rubber dam at the next visit in relation to the patient's current experience of rubber dam for each patient group

Time taken to apply.
The mean time taken by students to apply RD for all procedures was 4.65 min (SD 4.39) with a range of 1- 30 min and a mode of1min. For the four dentists, mean application time was 1.27 min (SD 1.03) with a range of 0.25-8 min and a mode of1 min. There was no difference in mean application times for either endodontic treatment or placement of restorations within each group. When compared with the patients’experience of rubber dam, there was no statistically significant difference between the mean application time for those who reportede ither a positive or a negative experience (SP, P = 0.58; DP, P = 0.43). The application times were also grouped in to short (<2 min), medium (2-5 min), and long application times (>5 min) (Table 4).The majority, 58%of SP experienced medium application times, whilst 76% of DP had short application times. No statistically significant association was found between application time and experience of rubber dam (SP, P = 0.99; DP, P = 0.75). Application time was also compared with the patients’preference for RD use next time. No statistically significant difference was found between the mean application times of each of the three preference categories (SP, P = 0.34; DP, P = 0.39). Using the application time categories above, there was no significant association between short, medium or long application times and the patient’s expressed preference for future RD use (SP, P = 0.45; DP, P = 0.47).

Table 4. The preference expressed for use of rubber dam at the next visit in relation to the time taken for its application for each patient group.

The preference expressed for use of rubber dam at the next visit in relation to the time taken for its application for each patient group

Duration of use.
The mean duration of RD use for all procedures by SP was 76.25 min (SD 36.57, range 15-180, mode 60 min) and for DP was 27.7 min (SD 13.38, range 2-70, mode 30 min). The mean duration time was longer for those from both groups who reported a negative current experience, but this did not reach statistical significance in either group (P = 0.07). Time durations were grouped, as with application times, into short (<45 min), medium (45-105 min) and long (>105 min) periods. Statistically, a significantly greater percentage of respondents in SP with short duration times reported a positive experience compared with those in the long-duration group (P < 0.01). In the medium-duration group, a greater percentage of positive experience was also reported compared with the long-duration group, but this did not reach statistical significance. Amongst DP, 82% experienced short duration times, with none having a duration over 70 min, so further analysis for DP in relation to duration would not have been meaningful.
Relating time duration preference for RD next time, no statistically significant difference was found amongst the mean duration times of the three preference categories (SP, P = 0.72; DP, P = 0.29). When preference was compared across the three time periods, no statistically significant association was found between duration of RD use and preference for its use in future (SP, P = 0.23; DP, P = 0.34).

Operator.
As might be expected, the mean application time and duration of RD was shorter for the experienced dentists than for the students. Students on average took 3.5times as long to apply dam compared to the dentists. The mean duration for students was over 1 h and just under 30 min for the dentists. Two-sample t-tests confirmed a statistically significant difference between the students and the dentists for both application time and duration (P < 0.01). A significantly greater percentage of dentists’ patients than student patients reported a positive current experience of RD and agreater preference for RD use at the next visit. There was also a significantly greater percentage of students’ patients who would not want rubber dam at the next visit than amongst the dentists’patients (P < 0.01for both).