Restorative Treatment Thresholds for Primary Caries by Dental PBRN Dentists

Objective: to explore the distributions of thresholds at which Dental Practice-Based Research Network (DPBRN) dentists report intervening surgically at various lesion depths for primary occlusal and interproximal caries lesions. DPBRN is a group of outpatient dental practices that have affiliated to investigate research questions (n=1166). DPBRN comprises 5 participating groups: AL/MS: Alabama/Mississippi, FL/GA: Florida/Georgia, HP/MN: dentists employed by HealthPartners and from the Minneapolis, Minnesota area, PDA: Permanente Dental Associates in cooperation with Kaiser Permanente Northwest Research Foundation, and SK: Denmark, Norway, and Sweden. Methods: A survey was sent to all DPBRN member dentists who perform restorative dentistry in their practices (n=915). Dentists were presented schematic photographs of primary caries at various stages of progression and case scenarios describing patients at various levels of caries risk and indicated for each combination whether they would intervene surgically. Chi-square tests were used to assess associations between reported stage of surgical intervention and dentist and practice characteristics and patient caries risk levels. Results: 532 DPBRN members responded. Forty eight percent of dentists indicated that they would surgically intervene for enamel lesions. DPBRN dentists from the AL/MS and FL/GA regions intervene significantly more on enamel lesions than dentists from the HP/MN, PDA, and SK regions (p<.0001). Dentists more readily choose intervention treatment on enamel surfaces when patients are in a high caries risk scenario (p<.0001). Conclusion: The decision to intervene surgically in the caries process differs by the depth of caries lesions, patient caries risk, and participating region. Support: U01-DE-16746, U01-DE-16747.