Changes in the Treatment Concept for Approximal Caries from 1983 to 2009 in Norway

Abstract

The aim was to measure variations in threshold for operative treatment of approximal caries in permanent teeth and the use of restorative materials, compared with results from studies conducted in Norway in 1983 and 1995. In 2009, a precoded questionnaire was sent electronically to 3,654 dentists with E-mail addresses in the member register of the Norwegian Dental Association. The questions were related to caries, treatment strategies and choice of dental materials. Replies were obtained from 61% of the dentists after two reminders. Restorative treatment of approximal lesions confined to enamel, based on radiographic appearance, was proposed by 7% of the dentists, compared with 66% in 1983 and 18% in 1995. Younger dentists, significantly more often than older, would defer operative treatment of approximal lesions until the lesion was visible in dentine. While tunnel preparation most often was the preparation of choice in 1995 (47%), saucer-shaped preparation was most favoured in 2009 (69%). Tunnel preparation was only preferred by 4% of the dentists. Resin composite was the restorative material preferred by 95%, compared with 16% in 1995. The corresponding values for conventional glass ionomer cement (GIC) were 1 versus 22%, for resin-modified GIC 1 versus 7%, and for a combination of GIC and resin composite 2 versus 22%. Compomer was preferred by 1% of the respondents. The authors conclude that treatment concepts for approximal caries have changed considerably during the last 26 years. In 2009, only 7% of dentists reported that they would treat approximal caries operatively before the lesion reached dentine.

Changes in Occlusal Caries Lesion Management in France from 2002 to 2012: A Persistent Gap between Evidence and Clinical Practice

“…Though the rate is lower than similar surveys conducted in Norway (61.3%) [Vidnes-Kopperud et al, 2011], the USA (57%) [Gordan et al, 2010] or Japan (67%) [Kakudate et al, 2012], it is typical of medical and dental questionnaire surveys in France, where, in a selection of recent studies, the response rate ranged from 16.6% to 54% [Bangerter et al, 2009;Benhamou et al, 2012;Drigeard et al, 2012;Herlin et al, 2008;Valgueblasse et al, 2012]. Nevertheless, the general demographic characteristics of the 2002 and 2012 respondents reflect well those of the French populations of GPs at the time of each study (Conseil de l'Ordre des Chirurgiens-Dentistes, France), allowing the authors to stipulate, despite the relatively low response rate, that the present results might be representative of the French GPs' attitudes towards the diagnosis and management of occlusal caries lesions.…”

“…Most of the questionnaire surveys conducted during the last decade among GPs have focused on approximal lesions [Baraba et al, 2010;Gordan et al, 2009;Heaven et al, 2013;Kakudate et al, 2012;Vidnes-Kopperud et al, 2011]. Therefore, less is known about diagnostic and management decisions for occlusal lesions Gordan et al, 2010;Heaven et al, 2013].…”

“…Questionnaire surveys investigating the restorative treatment threshold and caries management strategies (from diagnosis to treatment) among general practitioners (GPs) have become more and more popular during the last three decades and have been used in Croatia, France, Scandinavia, the USA, Japan, the Netherlands, Scotland, Australia and Chile [Baraba et al, 2010;Doméjean-Orliaguet et al, 2004;Espelid et al, 1985;Espelid et al, 2001;Gordan et al, 2009;Gordan et al, 2010;Gordan et al, 2011;Heaven et al, 2013;Kakudate et al, 2012;Mejare et al, 1999;Mileman and Espelid, 1988;Nuttall and Pitts, 1990;Riley et al, 2011;Rindal et al, 2012;Riordan et al, 1991;Ruiz et al, 2012;Sundberg et al, 2000;Tveit et al, 1999;Vidnes-Kopperud et al, 2011]. Questionnaire surveys are a useful and practical method to assess the actual caries management paradigm and how evidence-based MI preventive strategies (primary, secondary and tertiary prevention) are implemented in everyday clinical practice.…”

A novel classification system for assessment of approximal caries lesion progression in bitewing radiographs

“…Although it is recommended that operative intervention should not be performed unless there is cavitation 31,32 or if radiographs show definite lesion progression over time, 8 stated treatment thresholds to intervene surgically differ among clinicians. 33,34 For example, some clinicians would restore lesions restricted within the enamel in high-risk individuals. 35 It may, however, be dubious to base a decision of operative intervention on caries risk assessment, as evidence concerning the validity of existing methods for identifying individuals at high risk is limited.…”

Evaluation of Therapeutic Decision for Treatment of Carious Lesions by Dental Students

“…Moreover, the presence of radiolucency in the external enamel does not always correspond to cavitation [21,22]. For example, in one study, 64.16% of the 53 surfaces evaluated were not cavitated [23].…”