Management of cracked teeth: Perspectives of general dental practitioners and specialists

Objectives: The main aim of this study was to compare how general dental practitioners (GDPs), endodontists and prosthodontists diagnose, prognosticate, and treat cracked teeth. The secondary aim was to highlight factors influencing GDPs' referral practices of cracked teeth to specialists. Materials and methods: Questionnaires were used to collect information from GDPs, prosthodontists, and endodontists, on their use of diagnostic methods to identify cracked teeth, prognostication, and their management and referral practices for cracked teeth. Descriptive statistics were used to summarize the quantitative data. Pearson's Chi-Square test or Fisher's Exact test was applied to categorical variables while Kruskal-Wallis or Spearman's correlation coefficient was applied to continuous variables (p <0.05). Content analysis was performed for qualitative data. Results: 207 dentists responded, resulting in a response rate of 83.5%. Endodontists used more diagnostic tools as compared to prosthodontists and GDPs. For pulpally involved cracked teeth, endodontists were more likely to recommend root canal treatment (RCT) and cuspal coverage compared to extraction, followed by prosthodontists then GDPs. Main reasons for referral of cracked teeth to specialists include uncertainty in diagnosis, difficulty in crack visualization after endodontic access, and cracked teeth indicated for RCT. Conclusion: GDPs, prosthodontists, and endodontists differ in terms of their diagnosis, prognostication, and treatment of cracked teeth. GDPs refer cracked teeth to specialists due to challenges faced in diagnosis and treatment. Future research and education are required to provide evidence-based guidelines in the management of cracked teeth so that patients with cracked teeth can receive standardized care.