Practitioners’ Adherence to Instructions When Using Dental Adhesives

Objectives: This questionnaire based cross-sectional study evaluates the adherence of general dental practitioners (GDPs) and specialists in the UK & Middle East (ME) to manufacturers’ instructions when using dental adhesives (DAs).

Methods: A self-administered questionnaire was developed to collect quantitative and qualitative data in relation to the manufacturer instructions of popular DAs. A total of 312 UK and ME dental practitioners were distributed with the questionnaire, which enquired about their: i) demographics, ii) assessment of the level of usage of dental adhesives, iii) bonding techniques used and iv) feedback related to manufacturers’ instructions. Responses were collated and analysed against respective manufacturers’ ‘Instructions For Use’ documents (Hard Scoring), and these instructions combined with scientific literature guidelines (Soft Scoring).
Results: 98% (n=307/312) responses were received. Only 2.2% (n=7/312) of practitioners fully adhered to manufacturers’ instructions (Hard Scoring) when using DAs. Soft scoring guidelines adherence was higher with 16.4% (n=18/110) UK based GDPs, 43.1% (n=22/51) UK specialists; 9.1% (n=10/110) ME based GDPs and 41.7% (n=15/36) ME specialists reported following either manufacturers’ instructions or current literature. This data demonstrated (i) DAs used, (ii) year of qualification, and (iii) possession of post-graduate qualifications, were factors affecting hard scoring results. Younger practitioners and those with postgraduate qualifications adhered more to manufacturers’ instructions. Qualitative data highlighted some dissatisfaction with manufacturers’ instructions due to: i) small print size, ii) too many languages on a single document and iii) a lack of pictorial instructions.
Conclusions: Adherence to manufacturers’ instructions is important for the optimal use of DAs. Dentists’ overall adherence to these instructions was poor. Awareness of the variations between strict adherence to manufacturers’ instruction against the standards espoused by literature, of (i) the adhesive used, (ii) the chemistry of adhesive procedures, and (iii) the experience of the practitioner may also help to produce clinically acceptable outcomes.