Restorative intervention thresholds and treatment decisions of general dental practitioners in London

Abstract

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Restorative treatment decisions regarding approximal and occlusal carious lesions among general dental practitioners in Palestine

“…The majority (60.7% out of 770) of the respondents to a survey in France would wait until the lesion was in dentine (grade 3 to 5) while 39.3% would restore a lesion confined to enamel (grades 1 and 2) 10 . The results of the present study are consistent with previous studies [8][9][10][11]13 , the majority of the respondents (93.9%) would postpone operative treatment until the lesion was in dentine (grade 3 to 5) and fewer (6.1%) would start operative treatment earlier for a lesion confined to enamel (grade 1 and 2). However, Gordan et al 19 stated that not all of the thresholds are appropriate; some may be too conservative and some too aggressive, but no one has yet identified the "right" threshold.…”

“…Studies from different countries have shown variations among dental practitioners in terms of restorative treatment thresholds. Chana et al 11 reported that 84.8% (n=217) of the dentist who responded to a survey investigating the restorative treatment decisions in London preferred a conservative approach by only opting to operatively treat dentine lesions. In Norway, out of 2375 respondents, only 12.3% would restore posterior occlusal enamel lesions (grades 1-2) compared with 87.7% who would tend to defer operative treatment until the lesion had manifested in the dentin (grade 3 to 5) 8 .…”

“…The thresholds for restorative treatment among dentists in the clinical settings have been studied in many countries and a wide variation in treatment modalities between and within study populations have been shown. Educational background and years of experience of the dental clinical practitioner seem to govern treatment decisions all over the world [8][9][10][11][12][13][14][15] . However, there have not been any studies of this nature conducted in Palestine.…”

Restorative thresholds for primary and permanent molars in children: French dentist decisions

“…In a child with risk factors under control, about 50% and 40% of Fr‐DTCs would use the same restorative materials in both primary and permanent molars for occlusal and approximal lesions, respectively (Table 7). Composite resin was preferred at least three in four times for both occlusal and approximal lesions in permanent teeth, which confirms the worldwide trend to prefer composite resin 14,25,26,37 . Indeed, composite resin is the most likely to survive in permanent and primary teeth 38 .…”

“…This hypothesis is confirmed by the results from Australia with the present questionnaire: The proportion of dentists with an invasive strategy increased from 7% to 33% by changing ICDAS 1, 2 to ICDAS 1‐3 (ie, the initial proportion of dentists with an inappropriate operative decision was approximately four times higher 14 ). The second explanation could be a more invasive strategy for occlusal lesions in young patients by comparing the present results and studies of adults in France 18 and abroad 12,25,26 . This decision in children contradicted the strong scientific evidence for the use of therapeutic sealants for non‐cavitated lesions.…”