Objectives Few studies have examined dentists' subjective ratings of importance of caries risk factors or tested whether dentists use this information in treatment planning. This study tested several hypotheses related to caries risk assessment and individualized caries prevention. Methods Data were collected as part of a questionnaire entitled “Assessment of Caries Diagnosis and Caries Treatment”, completed by 547 practitioners who belong to The Dental Practice-Based Research Network (DPBRN), a consortium of participating practices and dental organizations. Results Sixty-nine percent of DPBRN dentists perform caries risk assessment on their patients. Recently-graduated dentists, dentists with busier practices, and those who believe a dentist can predict future caries were the most likely to use caries risk assessment. The association between caries risk assessment and individualized prevention was weaker than expected (r=.21). Dentists who perform caries risk assessment provide individualized caries prevention to 57% of their patients, compared to 42% for dentists who do not perform caries risk assessment. Based on their responses to radiographic and clinical scenarios in the questionnaire, dentists who use caries risk assessment appear to use this information in restorative decisions. Conclusion A substantial percentage of DPBRN dentists do not perform caries risk assessment, and there is not a strong linkage between its use and use of individualized preventive regimens for adult patients. More progress in implementation of current scientific evidence in this area is warranted.

Objectives To identify factors that are significantly associated with dentists’ use of specific caries preventive agents in adult patients, and whether dentists who use one preventive agent are also more likely to use certain others. Methods Data were collected from 564 practitioners in The Dental Practice-Based Research Network, a multi-region consortium of participating practices and dental organizations. Results In-office topical fluoride was the method most frequently used. Regarding at-home preventive agents, there was little difference in preference between non-prescription fluoride, prescription fluoride, or chlorhexidine rinse. Dentists who most frequently used caries prevention were also those who regularly perform caries risk assessment and individualize caries prevention at the patient level. Higher percentages of patients with dental insurance were significantly associated with more use of in-office prevention modalities. Female dentists and dentists with more-recent training were more likely to recommend preventive agents that are applied by the patient. Dentists who reported more-conservative decisions in clinical treatment scenarios were also more likely to use caries preventive agents. Groups of dentist who shared a common preference for certain preventive agents were identified. One group used preventive agents selectively, whereas the other groups predominately used either in-office or at-home fluorides. Conclusions Caries prevention is commonly used with adult patients. However, these results suggest that only a subset of dentists base preventive treatments on caries risk at the individual patient level.