2015 Volume 58 Issue 1 Pages 1-9
Purpose: Most dental treatments are performed at private dental clinics, while some of them are referred to secondary or tertiary dental care institutions. Although the number of missing teeth caused by fracture has been increasing recently, there are few reports on the present situation of tooth fracture in Japan. The purpose of this study was to identify the problems and demands of present dental practice by surveying patients with tooth fracture visiting the endodontic outpatient clinic of a university dental hospital.
Methods: The subjects were new patients who visited the endodontic outpatient clinic of Tokyo Medical and Dental University for 22 days in June 2011. Their teeth and chief complaints were surveyed based on dental records and X-ray films after examination.
Results: The number of patients was 462. Of these, the chief complaint of 118 patients (25.5%) was thought to be caused by tooth fracture. A fracture line was found in 44 (37.3%) of the 118; whereas tooth fracture was not found but was inferred from other findings in the other 74 patients (62.7%). Of the 462 patients, 134 (29.0%) consulted our hospital directly without consulting a private clinic and receiving a referral (①); 111 (24.0%) were referred from private clinics (②); 76 (16.5%) consulted our hospital without a referral even though they had been treated at a private dental clinic, as they wanted our hospital to treat or judge the validity of their treatment because the symptoms remained (③); 55 (11.9%) wanted our hospital to provide a second opinion about the validity of the diagnosis or treatment plan provided by a private clinic (④); 86 (18.6%) were referred from other outpatient clinics of our hospital (⑤). The number of tooth fracture cases of ① to ⑤ were 20 (14.9%), 25 (22.5%), 26 (34.2%), 25 (45.5%) and 21 (24.4%), respectively.
Conclusions: This survey revealed the following regarding tooth fracture.
1. There is a great demand for endodontic outpatient clinics. 2. It is necessary to educate general dentists about diagnostics. 3. Objective diagnostics at an early stage should be established. 4. It is necessary to inform patients that tooth fracture may require tooth extraction.
