title: Evidence-practice gap for dental sealant application: results from a dental practice-based research network in Japan.
abstract: OBJECTIVE
  The study aims were: (i) to examine dentist practice patterns regarding treatment recommendations for dental sealants; and (ii) to identify characteristics associated with this recommendation.
  
  
  METHODS
  The study was performed using a cross-sectional questionnaire survey (Clinicaltrials.gov registration number NCT01680848). Participants were Japanese dentists (n = 282) recruited from the Dental Practice-based Research Network Japan. Three clinical photographs of the occlusal surface of a mandibular first molar were presented, portraying increasing depths of cavitation in a 12-year-old patient with high caries risk. Sealants would be an appropriate treatment in all three scenarios. We asked about the treatment decision for each case. We then performed multiple logistic regression analyses to evaluate associations between the decision to recommend sealants, and dentist, patient and practice characteristics.
  
  
  RESULTS
  Responses were obtained from 189 dentists (response rate = 67%). In the hypothetical scenarios, dentists' recommendations for sealants for the 12-year-old patient varied from 16% to 26% across the three hypothetical clinical scenarios. Multiple logistic regression analysis indicated that dentist agreement with the efficacy of assessment for caries risk showed a significant association with the percentages of patients receiving sealants.
  
  
  CONCLUSIONS
  Dentist practice patterns for sealant treatment recommendation show changes that are dependent on caries severity. The dentists' recommendations for sealants for the 12-year-old patient were low for all three selected scenarios, based on indications for sealants in the American Dental Association guidelines. Recommending a sealant showed a significant relationship with the dentist having a higher agreement with efficacy of caries risk assessment.
authors.affiliation: Graduate School of Media and Governance, Keio University, Fujisawa City, Kanagawa, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Yokoyama
authors.affiliation: Division of Clinical Epidemiology, Kyushu Dental University, Kitakyushu, Fukuoka, Japan.|University of Florida College of Dentistry, Gainesville, FL, USA.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kakudate
authors.affiliation: Mikami Dental and Orthodontics Clinic, Tomakomai, Hokkaido, Japan.
authors.forename: Futoshi
authors.initials: F
authors.lastname: Sumida
authors.affiliation: Matsumoto Dental Clinic, Okazaki, Aichi, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Matsumoto
authors.affiliation: Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Gregg H
authors.initials: GH
authors.lastname: Gilbert
authors.affiliation: Department of Restorative Dental Sciences, University of Florida College of Dentistry, Gainesville, FL, USA.
authors.forename: Valeria V
authors.initials: VV
authors.lastname: Gordan
mesh_terms: D003430:Cross-Sectional Studies; D003731:Dental Caries / Q000517:prevention & control; D055094:Evidence-Based Dentistry / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan; D008297:Male; D010895:Pit and Fissure Sealants / Q000627:therapeutic use*; D019239:Practice Patterns, Dentists' / Q000706:statistics & numerical data*; D018570:Risk Assessment; D011795:Surveys and Questionnaires
chemical_list: D010895:Pit and Fissure Sealants
keywords: Dental sealant; clinical epidemiology; dental practice patterns; evidence-based dentistry; evidence-practice gap; practice-based research