Treatment decisions regarding caries and dental developmental defects in children - a questionnaire-based study among Norwegian dentists

Abstract

Background Current knowledge on treatment strategies and choice of restorative materials when treating deep caries or severe dental developmental defects (DDDs) in young individuals is scarce. Therefore, the aim was to investigate Norwegian dentists´ treatment decisions and reasons for treatment choice when treating deep caries in primary teeth and severe DDDs in permanent teeth in children. Methods A pre-coded questionnaire was sent electronically to all dentists employed in the Public Dental Service (PDS) in Norway ( n = 1294). The clinicians were asked about their background characteristics and how often they registered DDDs. Three clinical cases were presented to the dentists and asked to prioritize treatment options and reasons for their choice. Results After three reminders, 45.8% of the dentists answered. Most clinicians were general practitioners (96.3%), females (77.9%), under 41 year-olds (59.4%), graduated in 2001 or later (61.1%), and representing all regions of Norway. The respondents registered molar incisor hypomineralisation (MIH), other DDDs and dental fluorosis (DF) frequently, 523 (91.1%), 257 (44.8%) and 158 (27.5%), respectively. In case 1a with severe dental caries in a primary molar, the preferred treatment was resin-modified glass ionomer cement (RMGIC) (58.3%), followed by glass ionomer cement (GIC) (17.9%) and zinc oxide-eugenol (ZOE) (13.2%). Extraction, compomer or stainless steel crowns (SSC) were preferred by 0.9, 0.7 and 0.4%, respectively. In case 1b, which was identical to case 1a, but treated under general anaesthesia, the preferred treatment alternatives were RMGIC (37.1%), resin composite (RC) (17.6%) and GIC (17.2%). Extraction and SSC were chosen by 15.1 and 7.2%, respectively. In case 2, showing a severely hypomineralised and symptomatic first permanent molar, the dentists preferred RC (38.4%), followed by RMGIC (26.6%) and GIC (19.0%). Extraction and SSC were chosen by 8.7 and 5.4%, respectively. The treatment choices were not significantly affected by the dentists’ background characteristics. The reasons for dentists’ treatment decisions varied for each patient case; patient cooperation, prognosis of the tooth and own experience were the dominant reasons. Conclusions A notable disparity in treatment choices was shown indicating that Norwegian dentists evaluate each case individually and base their decisions on what they consider best for the individual patient.

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 .…”

“…Indeed, composite resin is the most likely to survive in permanent and primary teeth 38 . The restorative material used in France for different tooth surfaces in primary molars, however, was, in decreasing order, GIC/compomer, composite resin, and others, as in Norway 37 . As already reported in other studies, 14 different types of GIC/compomer materials were preferred for primary molars, whatever the considered surfaces.…”

German Dentists’ Preferences for the Treatment of Apical Periodontitis: A Cross-Sectional Survey

“…Furthermore, the practice of dentistry imitates market principles in which the patients’ or clinicians’ sensitivity to financial burdens, costs, and health insurance coverage of different treatments besides the patients’ cooperation might influence the treatment decision by dentists and their patients [ 31 , 32 ]. Treatment recommendations or decisions might also be affected by the medical and dental history of the patient [ 33 ], as well as the specific tooth or surface to be treated [ 34 ], in which the dental community also tends to disagree. Indeed, all factors affecting the treatment decisions by oral healthcare professionals can be divided into patient-related (PRF), practice/education-related (ERF), and tooth-related factors (TRF), providing the base for dentists in their judgements and treatment planning [ 35 , 36 ].…”

Step-by-step teaching method: improving learning outcomes of undergraduate dental students in layering techniques for direct composite resin restorations

“…TDIs are more prevalent in children and adolescent, and mainly involve the maxillary central incisors in young permanent teeth [2]. Dental caries and dental abnormalities are other common causes of defects in young permanent teeth [3]. These defects in young permanent teeth, particularly in the anterior region, might cause significant esthetic, functional, and psychosocial problems in children, and often require attention [4].…”