https://orcid.org/0000-0002-7113-7827
Abstract
Background
Physicians are more likely to examine children than dentists; thus, they may have a significant role in detecting oral and dentofacial problems. This study aimed to determine the rate and comprehensiveness of examinations, the rate and quality of referral practices, and the predictors of referral practice of physicians regarding orthodontic problems among children.
Methods
In a multi-center cross-sectional study, a total of 518 physicians in Saudi Arabia were subjected to an e-questionnaire of four sections: (1) Physicians’ demographic and work-related characteristics; (2) Physicians’ comprehensiveness of oral and orthodontic examinations; (3) Physicians’ referral practices to orthodontists and reasons considered for referral; and (4) Physicians’ sources of orthodontic education. Logistic regression analysis was applied to identify the significant predictors of referral practice. The significance was set at p < 0.05.
Results
Most physicians reported partial oral (78.5%) and orthodontic (72.2%) examinations, while the full examination was reported by only 12% and 2.5% of physicians, respectively. Referral to orthodontists was practiced by most of the physicians (83.8%), yet for the majority of them, the quality of referral was poor (40.3%) or fair (46.1%), with only 13.6% who practiced quality referral. Dental development issues (53.3%) and functional issues (51.5%) were reported as the main reasons for referral, followed by family/patient request (42.9%), dental alignment (42.5%), oral respiratory issues (32.4%), and finally jaw relation (26.1%). Referral practice was predicted by the comprehensive oral (OR = 2.37, p = 0.007) and orthodontic (OR = 4.26, p < 0.001) examinations, number of patients seen by the physician (OR = 1.58, p = 0.007), and level of training (OR = 1.88, p = 0.03).
Conclusion
Although most physicians reported high rates of examination and referral practices on orthodontic problems among children in Saudi Arabia, only a small portion showed comprehensive examinations and quality referral practice. Including dental courses in medical curricula and improving oral and orthodontic examination guidelines for physicians are recommended.
Abbreviations
KAMC King Abdulaziz Medical city; MNGHA Ministry of National Guard-Health Affairs; KAIMRC King Abdullah International Medical Research Center; IRB Institutional Review Board.
Data Sharing Statement
Most of the data supporting our findings is contained within the manuscript, and all others, excluding identifying/confidential data, will be shared upon request from the corresponding author [[email protected]].
Ethics Approval and Consent to Participate
Participation in this study was voluntary. Participants were assured in a written informed consent that their responses would remain anonymous. They were asked to respond to the survey if they agreed to the informed consent. The study protocol was approved by the Institutional Review Board (IRB) of the Ministry of National Guard-Health Affairs (MNGHA), Riyadh, Saudi Arabia (Ref. # RSS22R/021/07). This study was conducted in accordance with the Declaration of Helsinki.
Acknowledgment
This study was initiated by King Abdullah International Medical Research Center, and King Saud bin-Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. The study was one of the research projects of the 13th Research Summer School program conducted during July–August 2022, under the full supervision of the KAIMRC staff. All individuals included in this section have consented to the acknowledgement. The abstract of this paper was presented at the 7th Health Professions Conference, King Saud bin Abdulaziz University for Health Sciences, as a poster presentation with interim findings on December 25, 2022.
Author Contributions
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis, and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Disclosure
The authors declare that they have no competing interests in this work.