Revista Cubana de Estomatología (May 2019)

Decision-making for the treatment of occlusal caries in the Brazilian public health system

  • Cátia Gomes,
  • Barbara Nayalle,
  • Valéria Fernandes Maranhão,
  • Kátia Virginia Guerra Botelho,
  • Mônica Heimer,
  • Valdeci Elias Santos

Journal volume & issue
Vol. 56, no. 2
pp. 162 – 173

Abstract

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Introduction: Caries diagnosis errors have become a public health problem. Objective: Verify the consistency in terms of decision-making between Brazilian dentists from the country's public health system and the International Caries Detection and Assessment System (ICDAS), and evaluate the influence of professional experience on the management of the decay. Methods: There are 80 dentists in the public health service of Recife city, Brazil. All dentists were invited to participate in this cross-sectional study. Forty dentists agreed to answer questions about their decision-making in relation to the treatment of occlusal caries in low, moderate and high-risk caries situations. The time of clinical experience, the use of methods for the assessment of caries risk and the lesion activity were also inquired about. The T-test was applied with a significance level of 5 % to compare the correlation between the International Caries Detection and Assessment System scores regarding the mean age of participants. Results: The disagreement between the dentists and the criteria used by the International Caries Detection and Assessment System for decision-making were mainly related to the sound surfaces or lesions restricted to the tooth enamel. It was thus verified that lack of consistency for the low-risk condition reached a score of 3 (32 %), while moderate (95 %) and high-risk (85 %) conditions lay at a classification code of 0. The time of professional experience was not considered to have interfered with decision-making on any scale, regardless of the risk condition of the patient (p> 0.05). Conclusions: A divergence in terms of decision-making between dentists of the public health system and the International Caries Detection and Assessment System could be observed, specifically regarding sound surfaces or surfaces with lesions restricted to the tooth enamel. Furthermore, professional experience was seen as not influencing the management of caries.

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