Dentists’ use of caries risk assessment and individualized caries prevention for their adult patients: findings from The Dental Practice-Based Research Network

Abstract

Objectives Few studies have examined dentists' subjective ratings of importance of caries risk factors or tested whether dentists use this information in treatment planning. This study tested several hypotheses related to caries risk assessment and individualized caries prevention. Methods Data were collected as part of a questionnaire entitled “Assessment of Caries Diagnosis and Caries Treatment”, completed by 547 practitioners who belong to The Dental Practice-Based Research Network (DPBRN), a consortium of participating practices and dental organizations. Results Sixty-nine percent of DPBRN dentists perform caries risk assessment on their patients. Recently-graduated dentists, dentists with busier practices, and those who believe a dentist can predict future caries were the most likely to use caries risk assessment. The association between caries risk assessment and individualized prevention was weaker than expected (r=.21). Dentists who perform caries risk assessment provide individualized caries prevention to 57% of their patients, compared to 42% for dentists who do not perform caries risk assessment. Based on their responses to radiographic and clinical scenarios in the questionnaire, dentists who use caries risk assessment appear to use this information in restorative decisions. Conclusion A substantial percentage of DPBRN dentists do not perform caries risk assessment, and there is not a strong linkage between its use and use of individualized preventive regimens for adult patients. More progress in implementation of current scientific evidence in this area is warranted.

Status of Preventive Caries Management Skills of Clinical Students Studying in Various Dental Colleges in Karachi, Pakistan

“…Though shifting from one philosophy to another one is challenging and will need patience and determination over the period of time to make CAMBRA the custom for caries management in the country. [18,19] The limitation of the study requires mentioning here is the data comprise of dental colleges from one city of Pakistan. More comprehensive studies are recommended including institutions from other parts of the country to collect representing data.…”

“…[8][9][10][11][12][13][14] Despite the proven efficacy of these preventive modalities, they are not implemented in clinical dental practices todate in many countries worldwide. [15][16][17][18][19] To involve this evidence -based research into clinical practice, educationalists in USA made preventive caries management, an integral part of curriculum of their undergraduate dental education programs. The clinical students were emphasized to manage caries by risk -based model instead of traditional surgical model.…”

“…As a result, in USA after two decades, the students who received the preventive -based training when became clinicians Section: Dentistry started practicing it and the idea to treat caries by surgical intervention is gradually being replaced by preventive approaches. [17][18][19][20][21][22] Like many other countries, Pakistan seems to be a country where the dentists don't follow preventive -based protocols in their clinical practices. According to a study done very recently, dentists from Pakistan working in Saudi Arabia were found to place intracoronal restorations as a primary solution to treat caries.…”

The application of caries risk assessment in minimum intervention dentistry

“…48,49,52,59,60,65,66 Most studies conclude that past caries experience is still the most reliable predictor of future caries experience in children and that a clinician's intuition or 'gut feeling' is often more accurate than current diagnostic technologies. 3,5,7,44,46,47,67,68 Unfortunately, active dental caries presence negates primary disease prevention in a literal MID sense and a clinician's intuition is not easily quantifiable for the statistical validation of this criterion in any prediction model. The challenge to researchers in this field is to identify other accurate and reliable markers for future caries experience that a clinician can use quickly and inexpensively.…”

“…44,68 Structured questionnaire forms are reportedly used by only 14% of dentists, and most dentists assess their patient's caries risk through their clinical observation and experience. 68 Nowadays, new technologies can potentially be used to supplement the clinician's detection of the early carious lesion leading to enhanced diagnostic criteria for risk assessment. 42 The clinical application of new diagnostic technologies will be reviewed by Professor David Manton in this supplement.…”