Exploring How U.S. Dental Schools Teach Removal of Carious Tissues During Cavity Preparations

Abstract

Approaches for managing carious tissues during cavity preparations vary considerably among clinicians, which may reflect inconsistencies in the teaching of this subject by dental schools. The aims of this study were to investigate practices related to the preclinical and clinical teaching of caries removal at U.S. dental schools and the relationship between that teaching and requirements for U.S. dental licensure examinations. The electronic survey included questions about terminology, methods, instruments and materials, treatment planning, criteria for clinical exams, faculty calibration sessions, and licensure exams. The faculty members at U.S. dental schools responsible for teaching cariology were invited to participate; 54 of the 65 schools had identified a contact person at the time of the survey in October 2015. Of those 54 invited to participate, 43 completed the survey (response rate of 79.6%). Most of the respondents indicated that depth of carious lesions was a clinical determinant of the amount of carious dentin being removed in cavity preparations. Caries removal was used as a criterion in restorative clinical examinations by 95% of responding schools. Marked differences were observed regarding the criteria used for assessment and removal of carious tissues, management of deep carious lesions, and definition of "caries remaining at cavity preparations," which is considered a critical error on licensure exams. Faculty calibration sessions on caries removal were reported to occur in 65% of these schools and at different time frames. Overall, the study found a wide range of teaching practices related to caries removal. Best evidence in caries management needs to be aligned with teaching and the criteria used to calibrate faculty members and examiners.

Investigating the construct validity of a haptic virtual caries simulation for dental education

“…3B). While clearing the ADJ is standard procedure for practitioners, the amount of deep caries to remove is not [3,6]. Hence, we may expect a greater deviation among participants with the deep caries removal than the ADJ caries.…”

“…Plastic teeth containing pathology and anatomical features are available but are currently considered too costly by most institutions for regular educational use. Problematically, plastic teeth do not allow for any insight into tactile perception, despite this being recognized as an essential requirement for successful caries removal [6]. Further, even the more elaborately constructed plastic teeth reportedly fail to realistically, and uniformly, simulate the difference in tactile feedback by the various simulated tissues [7].…”

Is Fluorescence Technology a Promising Tool for Detecting Infected Dentin in Deep Carious Lesions?

“…As a result, the disease is characterized by dissolution of hard tissues (enamel, dentin, and cementum), which occurs due to acidic bacterial byproducts of carbohydrate fermentation, followed by loss of the protein matrix. This is a dynamic process, causing significant mineral loss that can culminate with a cavitation in enamel and in dentin [Summitt, 2006;Nascimento et al, 2017].…”

Creación de un Currículo de Competencias en Cariología para Estudiantes de Pregrado de Odontología en Chile.

“…En general, la educación de pregrado en Cariología muestra variadas estrategias metodológicas en el proceso de enseñanza-aprendizaje, siendo necesario trabajar en su reformulación y alcanzar optimizaciones en los criterios aplicados para entrenar a profesores y estudiantes (18) . Frente a esta realidad, se propone como objetivo, la creación de un currículo de competencias mínimas en Cariología, para la formación de los Cirujano-Dentistas egresados de las escuelas dentales de pregrado de Chile.…”