title: Are more endodontic consultations needed in dental school clinic settings? A study of treatment decisions at one school.
abstract: With no previous studies of the occurrence of interdisciplinary consultations for tooth extraction in a dental school clinic setting, the aim of this cross-sectional descriptive investigation was to measure and compare the consultation process that occurred among departments at one U.S. dental school for making treatment decisions on tooth extraction. A comprehensive computerized retrieval (Crystal Reports) was used to identify and gather data from patient records from July 1, 2007, to July 1, 2011. Treatment plans and progress notes were analyzed to determine why each tooth had been extracted and which department had recommended the extraction. Results showed that the clinical departments involved in treatment planning decisions were the DMD dental student clinic, Department of Periodontics, and Department of Endodontics. The narrative records of 227 patients who had 516 teeth extracted were examined. About three-fourths (73.26%) of the extracted teeth were extracted based on the recommendation of only one department. Of these extracted teeth, 22.0% (n=114) were previously endodontically treated, and only four were recommended for endodontic consultation prior to extraction. The study found that most extractions were performed without specialty consultations and that the Department of Endodontics was consulted the least of all departments. To foster interdisciplinary collaboration in dental school clinics and help students develop expertise in such collaborations, more specialty consultations are needed for teeth that are treatment planned for extraction in order to preclude needless extraction of potentially salvageable teeth. Doing so will provide benefits for both patient care and students' education.
authors.affiliation: Dr. Aminoshariae is Assistant Professor, Department of Endodontics and Director of Predoctoral Endodontics, School of Dental Medicine, Case Western Reserve University; Dr. Tulunoglu is Associate Professor, Department of Comprehensive Care, School of Dental Medicine, Case Western Reserve University; Dr. Demko is Associate Professor, Department of Community Dentistry, School of Dental Medicine, Case Western Reserve University; Dr. Galsterer is a former Resident, Department of Endodontics, School of Dental Medicine, Case Western Reserve University; Dr. Montagnese is Assistant Professor, Department of Endodontics, School of Dental Medicine, Case Western Reserve University; and Dr. Mickel is Associate Professor, Director of Endodontics Residency Program, and Chair of Department of Endodontics, School of Dental Medicine, Case Western Reserve University. Axa53@case.edu.
authors.forename: Anita
authors.initials: A
authors.lastname: Aminoshariae
authors.affiliation: Dr. Aminoshariae is Assistant Professor, Department of Endodontics and Director of Predoctoral Endodontics, School of Dental Medicine, Case Western Reserve University; Dr. Tulunoglu is Associate Professor, Department of Comprehensive Care, School of Dental Medicine, Case Western Reserve University; Dr. Demko is Associate Professor, Department of Community Dentistry, School of Dental Medicine, Case Western Reserve University; Dr. Galsterer is a former Resident, Department of Endodontics, School of Dental Medicine, Case Western Reserve University; Dr. Montagnese is Assistant Professor, Department of Endodontics, School of Dental Medicine, Case Western Reserve University; and Dr. Mickel is Associate Professor, Director of Endodontics Residency Program, and Chair of Department of Endodontics, School of Dental Medicine, Case Western Reserve University.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Tulunoglu
authors.affiliation: Dr. Aminoshariae is Assistant Professor, Department of Endodontics and Director of Predoctoral Endodontics, School of Dental Medicine, Case Western Reserve University; Dr. Tulunoglu is Associate Professor, Department of Comprehensive Care, School of Dental Medicine, Case Western Reserve University; Dr. Demko is Associate Professor, Department of Community Dentistry, School of Dental Medicine, Case Western Reserve University; Dr. Galsterer is a former Resident, Department of Endodontics, School of Dental Medicine, Case Western Reserve University; Dr. Montagnese is Assistant Professor, Department of Endodontics, School of Dental Medicine, Case Western Reserve University; and Dr. Mickel is Associate Professor, Director of Endodontics Residency Program, and Chair of Department of Endodontics, School of Dental Medicine, Case Western Reserve University.
authors.forename: Catherine
authors.initials: C
authors.lastname: Demko
authors.affiliation: Dr. Aminoshariae is Assistant Professor, Department of Endodontics and Director of Predoctoral Endodontics, School of Dental Medicine, Case Western Reserve University; Dr. Tulunoglu is Associate Professor, Department of Comprehensive Care, School of Dental Medicine, Case Western Reserve University; Dr. Demko is Associate Professor, Department of Community Dentistry, School of Dental Medicine, Case Western Reserve University; Dr. Galsterer is a former Resident, Department of Endodontics, School of Dental Medicine, Case Western Reserve University; Dr. Montagnese is Assistant Professor, Department of Endodontics, School of Dental Medicine, Case Western Reserve University; and Dr. Mickel is Associate Professor, Director of Endodontics Residency Program, and Chair of Department of Endodontics, School of Dental Medicine, Case Western Reserve University.
authors.forename: Mark
authors.initials: M
authors.lastname: Galsterer
authors.affiliation: Dr. Aminoshariae is Assistant Professor, Department of Endodontics and Director of Predoctoral Endodontics, School of Dental Medicine, Case Western Reserve University; Dr. Tulunoglu is Associate Professor, Department of Comprehensive Care, School of Dental Medicine, Case Western Reserve University; Dr. Demko is Associate Professor, Department of Community Dentistry, School of Dental Medicine, Case Western Reserve University; Dr. Galsterer is a former Resident, Department of Endodontics, School of Dental Medicine, Case Western Reserve University; Dr. Montagnese is Assistant Professor, Department of Endodontics, School of Dental Medicine, Case Western Reserve University; and Dr. Mickel is Associate Professor, Director of Endodontics Residency Program, and Chair of Department of Endodontics, School of Dental Medicine, Case Western Reserve University.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Montagnese
authors.affiliation: Dr. Aminoshariae is Assistant Professor, Department of Endodontics and Director of Predoctoral Endodontics, School of Dental Medicine, Case Western Reserve University; Dr. Tulunoglu is Associate Professor, Department of Comprehensive Care, School of Dental Medicine, Case Western Reserve University; Dr. Demko is Associate Professor, Department of Community Dentistry, School of Dental Medicine, Case Western Reserve University; Dr. Galsterer is a former Resident, Department of Endodontics, School of Dental Medicine, Case Western Reserve University; Dr. Montagnese is Assistant Professor, Department of Endodontics, School of Dental Medicine, Case Western Reserve University; and Dr. Mickel is Associate Professor, Director of Endodontics Residency Program, and Chair of Department of Endodontics, School of Dental Medicine, Case Western Reserve University.
authors.forename: Andre
authors.initials: A
authors.lastname: Mickel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003657:Decision Making; D003740:Dental Clinics; D003814:Dentistry, Operative / Q000193:education; D004497:Education, Dental; D004708:Endodontics / Q000193:education; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D010348:Patient Care Team; D057240:Patient Preference; D010483:Periapical Diseases / Q000628:therapy; D010517:Periodontics / Q000193:education; D012017:Referral and Consultation; D012189:Retrospective Studies; D012575:Schools, Dental / Q000458:organization & administration; D014081:Tooth Extraction; D014082:Tooth Fractures / Q000628:therapy; D014086:Tooth Mobility / Q000628:therapy; D019553:Tooth, Nonvital / Q000628:therapy; D055815:Young Adult
keywords: clinical education; dental education; dental school clinics; endodontics; patient care; tooth extraction; treatment consultation