Hands OnCalifornia dentists’ management strategies
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Background
The assessment of a patient’s caries risk and subsequent assignment of individualized preventive, nonoperative care measures based on risk has eliminated some of the invasive operative treatments formerly performed. If carious lesions are classified at a noncavitated stage, dentists can evaluate whether they can employ noninvasive measures, managing them by remineralization without restorative interventions. Whether the dentists in California are using these management strategies for approximal
Methods
A web-based questionnaire was distributed via e-mail to 16,960 dentists licensed in California. Questions concerned approximal and occlusal carious lesion management, including detection, restorative threshold, preferred preparation, and restorative materials used. A chi-square analysis was done to evaluate the relationship between management strategies and demographics of the responders. The response rate was 11.3% (1922 replies), with 1842 deemed qualified for the assessment.
Results
General practitioners accounted for 87.5% of the respondents and 12.5% were specialists, 5.9% of whom were pediatric dentists. Eighteen percent suggested using restorative management of approximal lesions and would not delay treatment for lesions confined to enamel. Nearly 43% would not delay treatment for a dentinoenamel junction lesion and 33.4% would restore the tooth when the lesion reached the outer third of the dentin.
The preferred preparation was a traditional Class II preparation
Discussion
The California dentists surveyed reported a wide range of restorative treatment choices. Although most agreed that their restorative treatment threshold was reaching the dentinoenamel junction, a third recommended the cavity preparation and restoration extend into the outer third of the dentin. Recent graduates and pediatric dentists were more likely to choose to restore deeper lesions than those who had been in practice longer. They still required training in distinguishing between cavitated
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Rechmann P, Doméjean S, Rechmann BMT, et al: Approximal and occlusal carious lesions: Restorative treatment decisions by California dentists. J Am Dent Assoc 147:328-338, 2016
Reprints available from P Rechmann, Clinical Sciences Research Group, Dept of Preventive and Restorative Dental Sciences, School of Dentistry, Univ of California, 707 Parnassus Ave, San Francisco, CA 94143; e-mail: [email protected]