Interest in periodontology and preferences for treatment of gingival recessions

Objectives: To evaluate the views, knowledge and preferences of a large sample of dentists in periodontics, focusing specifically on the treatment of gingival recessions, and to compare the findings with the current evidence available in the literature. Methods: Cross-sectional postal survey of 3780 dentists, representing the majority of all dentists working in Switzerland. The questionnaire consisted of 17 questions. The demographic profile, interests and satisfaction in periodontics were associated with the choice of treatment options offered for the management of six clinical situations. Results: 1201 dentists sent back the questionnaire within three months. In general, the interest and the satisfaction in periodontics were moderate to high (6-7 on an analogue scale from 1 to 10). Specialists in periodontics indicated a significantly higher interest and satisfaction in periodontics than the general dentists (p<0.001), and practitioners working in urban areas indicated a slightly higher interest (p=0.027) and satisfaction (0.047) than their colleagues established in a rural setting. The predominant indication of root coverage procedures was esthetics (90.7%). The region in which dentists worked was the only significant predictor for choosing “no treatment” of buccal recessions: Dentists from the German-speaking part were significantly less inclined to surgically treat gingival recessions than their colleagues from the French or Italian part. A free tissue graft was generally the favorite option, followed by a connective tissue graft and a coronally advanced flap. Throughout, only a small fraction of the dentists considered using a guided tissue regeneration procedure. The relative odds for not extracting teeth with severe periodontal disease were higher if the dentist was a specialist than a generalist. Satisfaction in practicing periodontics also positively strengthened the inclination towards keeping severely compromised teeth. Conclusions: Esthetic concerns were the predominant indication for root coverage procedures. Specific training of dentists and their satisfaction in periodontics influenced treatment decisions.