Patient Age and Dentists' Decisions About Occlusal Caries Treatment Thresholds

Abstract

Objectives This study was performed to (1) quantify dentists’ treatment thresholds for occlusal primary caries; (2) determine if patient's age affects dentists’ decisions to surgically treat these carious lesions; (3) test the hypothesis that patients’, dentists’, and practices’ characteristics are significantly associated with surgical enamel intervention. Methods The study used a cross-sectional design consisting of a questionnaire survey in Japan. This study queried dentists working in outpatient dental practices who were affiliated with the Dental Practice-Based Research Network Japan (JDPBRN), which aims to allow dentists to investigate research questions and share experiences and expertise (n=282). Participants were asked whether they would surgically intervene in a series of cases depicting occlusal caries. Each case included a photograph of an occlusal surface displaying typical characteristics of caries penetration, and written descriptions of adult and pediatric patients at high caries risk. Results In a case of a carious lesion within inner enamel, the proportion of dentists who indicated surgical intervention was significantly higher in the adult patient (48%) when compared to the pediatric patient (34%) (p< 0.01). Logistic regression analysis showed that using a dental explorer for the diagnosis of primary occlusal caries, type of practice, practice busyness, and percentage of patients who self-pay were significantly associated with dentists’ decisions to intervene surgically into the inner enamel carious lesion. Conclusions These findings demonstrate that over one-third of participants chose to intervene surgically into inner enamel carious lesions, and patients’ age affects dentists’ decisions about when to intervene surgically (clinicaltrials.gov registration number NCT01680848).

Use of clinical practice guidelines by dentists: findings from the Japanese dental practice‐based research network

“…The result on busyness showed that busier dentists tended to use the clinical practice guidelines more often. This result is consistent with previous analyses of dental practice patterns [25,26], which also demonstrated that busier dentists are more likely to practice evidence-based dentistry.…”

Occlusal Caries Management: Preferences among Dentists in Norway

“…Dentists' treatment decisions are shown to vary depending on patient characteristics such as age, dental status, caries risk and regularity of attendance [el-Mowafy and Lewis, 1994;Bader and Shugars, 1998;Bader et al, 2001;Gordan et al, 2010;Kakudate et al, 2012Kakudate et al, , 2014. In a low-risk case, dentists may be more liable to defer operative treatment than in patients at high caries risk.…”

Evidence‐practice gap for in‐office fluoride application in a dental practice‐based research network

“…Questionnaires were distributed to 282 dentists, from whom valid responses were obtained from 189 (67 percent). Demographic characteristics of participants are provided in Table 1 (7,(15)(16)(17)(18). Mean number of years (±standard deviation) since graduation from dental school was 18.5 ± 9.9.…”