Variation in decision-making –
treatment choice phase
n Strongly held beliefs
an extremely important determinant of treatment selection,
often in the absence of any supporting evidence
Belief  that crowns are superior to amalgams
• But no definitive survival analyses
• Or examinations of cost effectiveness are available to
support this belief
• And dentists’ estimates of the longevity of amalgams
and crowns vary widely
– Placing amalgams rather than sealants in fissures
– Also associated with strongly held beliefs about relative
effectiveness
• This time in the face of evidence for the effectiveness
of the less invasive procedures