Restorative treatment thresholds: factors influencing the treatment thresholds and modalities of general dentists in Kuwait

Mai E Khalaf 1, Qasem D Alomari, Hien Ngo, Sophie Doméjean

Affiliations

01 January 2014

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doi: 10.1159/000363184

Abstract

Objectives: This study investigated the thresholds at which general dentists in Kuwait would restore approximal and occlusal carious lesions and examined the demographic characteristics of the dentists in relation to their decision making.

Subjects and methods: The study population consisted of a random sample of 185 general dentists practicing in the Ministry of Health of Kuwait. A survey questionnaire was administered. The questionnaire presented different stages and locations of carious lesions; the participants were asked to identify the stage at which a restoration is required under different conditions, the preparation technique, and their choice of restorative material.

Results: For approximal carious lesions, 74 (40%) of the participants reported that they would restoratively intervene when the carious lesion reached the outer third of the dentin. A total of 91 (49.2%) reported the use of traditional class II restorations. For occlusal carious lesions, 128 (69.2%) said they would intervene when lesions reached the middle third of the dentin. 146 (78.9%) said they would remove the carious tissue only in their preparation. For both approximal and occlusal lesions, the participants preferred resin composite as the material for restoration.

Conclusions: The respondents tended to delay restorative intervention until dentinal penetration of the caries. Resin restorative materials were used in conservatively prepared cavities. Participants chose a conservative approach for occlusal lesions but still believed in a traditional approach when it concerned approximal lesions. Experience, university dental education, and participation in continuous education courses were most significantly related to restorative treatment.

Figures

Fig. 1 Illustration of the radiographic appearance of progressive (stages 1–6) approximal carious lesions.

Fig. 1 Illustration of the radiographic appearance of progressive (stages 1–6) approximal carious lesions.

Fig. 2 Photographs of progressive occlusal carious lesions. a No radiographic signs of lesions. b No radiographic signs of lesions. c Lesions on the outer third of the dentin on the bitewing radiograph. d Lesions on the middle third of the dentin on the bitewing radiograph e Lesions on the inner third of the dentin on the bitewing radiograph.

Fig. 2 Photographs of progressive occlusal carious lesions. a No radiographic signs of lesions. b No radiographic signs of lesions. c Lesions on the outer third of the dentin on the bitewing radiograph. d Lesions on the middle third of the dentin on the bitewing radiograph e Lesions on the inner third of the dentin on the bitewing radiograph.

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References

  1.  
    1. Marcenes W, Kassebaum NJ, Bernabé E, et al. Global burden of oral conditions in 1990–2010. J Dent Res. 2013;92:592–597. - PMC - PubMed
  2.  
    1. Behbehani JM, Scheutz F. Oral health in Kuwait. Int Dent J. 2004;54(suppl 1):401–408. - PubMed
  3.  
    1. Dennison JB, Hamilton JC. Treatment decisions and conservation of tooth structure. Dent Clin North Am. 2005;49:867–887. - PubMed
  4.  
    1. Mount GJ, Ngo H. Minimal intervention: a new concept for operative dentistry. Quintessence Int. 2000;31:527–533. - PubMed
  5.  
    1. McComb D. Systematic review of conservative operative caries management strategies. J Dent Educ. 2001;65:1154–1161. - PubMed
  6.  
    1. Murdoch-Kinch CA, McLean ME. Minimally invasive dentistry. J Am Dent Assoc. 2003;134:87–95. - PubMed
  7.  
    1. Lynch C, Frazier K, McConnell R, et al. Minimally invasive management of dental caries: contemporary teaching of posterior resin-based composite placement in US and Canadian dental schools. J Am Dent Assoc. 2011;142:612–620. - PubMed
  8.  
    1. Borges BC, Campos GB, da Silveira AD, et al. Efficacy of a pit and fissure sealant in arresting dentin non-cavitated caries: a 1-year follow-up, randomized, single-blind, controlled clinical trial. Am J Dent. 2010;23:311–316. - PubMed
  9.  
    1. Fyffe HE, Deery C, Nuttal NM, et al. Effect of diagnostic threshold on the validity and reliability of epidemiological caries diagnosis using the Dundee Selectable Threshold Method for caries diagnosis (DTSM) Community Dent Oral Epidemiol. 2000;28:42–51. - PubMed
  10.  
    1. Pitts NB. Modern concepts of caries measurement. J Dent Res. 2004;83:43–47. - PubMed
  11.  
    1. Bakhshandeh A, Qvist V, Ekstrand KR. Sealing occlusal caries lesions in adults referred for restorative treatment: 2–3 years of follow-up. Clin Oral Investig. 2012;16:521–529. - PubMed
  12.  
    1. Bader JD, Shugars DA. The evidence supporting alternative management strategies for early occlusal caries and suspected occlusal dentinal caries. J Evid Based Dent Pract. 2006;6:91–100. - PubMed
  13.  
    1. Ekstrand KR, Ricketts DN, Kidd EA, et al. Detection, monitoring and logical treatment of occlusal caries in relation to lesion activity and severity: an in vivo examination with histological validation. Caries Res. 1998;32:247–254. - PubMed
  14.  
    1. Sawyer KK, Donly KJ. Remineralization effects of a sodium fluoride biodegradable gel. Am J Dent. 2004;17:245–248. - PubMed
  15.  
    1. Bader JD, Shugars DA. What do we know about how dentists make caries-related treatment decisions? Community Dent Oral Epidemiol. 1997;25:97–103. - PubMed
  16.  
    1. Kay EJ, Locker D. Variations in restorative treatment decisions: an international comparison. Community Dent Oral Epidemiol. 1996;24:376–379. - PubMed
  17.  
    1. Espelid I, Tveit AB. A comparison of radiographic occlusal and approximal caries diagnoses made by 240 dentists. Acta Odontol Scand. 2001;59:285–289. - PubMed
  18.  
    1. Ministry of Health of Kuwait Dental Administration Statistics. http://www.moh.gov.kw/
  19.  
    1. Zafersoy-Akarslan Z, Erten H, Uzon O, et al. Reproducibility and agreement of clinical diagnosis of occlusal caries using unaided visual examination and operating microscope. J Can Dent Assoc. 2009;75:455. - PubMed
  20.  
    1. Ismail A. Visual and visuo-tactile detection of dental caries. J Dent Res. 2004;83:C56–C66. - PubMed
  21.  
    1. Tubert-Jeannin S, Domejean-Orliaguet S, Riordan P, et al. Restorative treatment strategies reported by French university teachers. J Dent Educ. 2004;68:1096–1103. - PubMed
  22.  
    1. Espelid I, Tveit A, Haugejorden O, et al. Variation in radiographic interpretation and restorative treatment decisions on approximal caries among dentists in Norway. Community Dent Oral Epidemiol. 1985;13:26–29. - PubMed
  23.  
    1. Pereira AC, Eggertsson H, Martinez-Mier EA, et al. Validity of caries detection on occlusal surfaces and treatment decisions based on results from multiple caries-detection methods. Eur J Oral Sci. 2009;117:51–57. - PubMed
  24.  
    1. Wilson NH, Lynch CD. The teaching of posterior resin composites: planning for the future based on 25 years of research. J Dent. 2014;42:503–516. - PubMed
  25.  
    1. Griffin SO, Oong E, Kohn W, et al. The effectiveness of sealants in managing caries lesions. J Dent Res. 2008;87:169–174. - PubMed

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