Dentists' perception of their treatment practices versus documented evidence

Objective: To compare the quality of real-life treatment practices to dentists' perceptions of treatment rendered. Setting: One administrative unit of the Finnish public oral health service. Methods: The original oral health records of a randomly selected sample of young adults who received treatment during 1994-1996 provided data on actual clinical examinations (n=208), radiographs (n=312), and root canal treatment courses (n=148) carried out by 50 dentists. Dentists' perceptions of the treatment rendered were obtained through a structured questionnaire completed during their working hours in 1996. Outcome measures: Criteria for assessing the quality of treatment practices were based on Finnish health legislation, authoritative instructions, and consensus reports. Results: Based on responses, 77% of the dentists followed the prevailing instructions on oral health record keeping (82%, if partial agreement included). Most dentists (88% fully agreed, 95% at least partly) perceived that their knowledge gained through continuing education was being applied in practice; no one answered no. A gap was found between dentists' perception of the treatment rendered and everyday treatment practices as recorded on patient documents. Conclusions: Overall, dentists' perception of the quality of their treatment practices exceeded that found in patient documents. This gap deserves consideration while planning research, education, or quality-improvement projects that relate to dentists' opinions.