Caries-related treatment decisions of general dental practitioners in Riyadh, Saudi Arabia

Abstract

Introduction: For decades, caries management strategies followed G. V. Black's concept, which has been considered an invasive approach since the development of operative care. Several studies showed a wide variation in restorative treatment decisions even among dentists within the same country. Aim: The aim of this study is to investigate treatment decisions for carious lesions in relation to the patients' caries risk among general practitioners. Materials and Methods: A cross-sectional study using a self-administered paper-based questionnaire was conducted among general dental practitioners in Riyadh city. The demographic characteristics of the practitioners were obtained. The questionnaire included five clinical scenarios aided by photographs; each scenario involved either a high- or a low-caries risk condition, and the scenarios were presented alternately. The recall interval was recorded. Occlusal and proximal caries thresholds were also explored. Data were analyzed using SPSS version 21 software. Chi-square and logistic regression analyses were conducted, and values of P ≤ 0.05 were considered statistically significant. Results: A total of 340 participants were included in the analysis. The treatment decisions of the general dental practitioners for the International Caries Detection and Assessment System code 2 scenarios were mostly preventive. Proximal carious lesions extending to the dentinoenamel junction were the principal indication for operative treatment. Most participants preferred to recall patients after 6 months. Conclusion: There was vast discordance between knowledge and practice in restorative treatment decisions for occlusal carious lesions. The general dentists tended to opt for restorative treatment in high-risk patients three times more often than in low-risk patients. Clinical Significance: A low level of clinical implementation of evidence-based information was observed in this study regarding occlusal caries.

Keywords

• caries risk
• carious lesions
• minimally invasive dentistry
• recall intervals
• treatment decision