Methods Used by Dental PBRN Clinicians to Diagnose Dental Caries

Objective: To describe differences in methods used by dentists across the regions of the Dental Practice Based Research Network (DPBRN) for diagnosing dental caries. 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 of methods used for caries diagnosis was sent to all DPBRN member dentists who perform restorative dentistry in their practices (n=915). Possible responses were visual examination, dental explorer, dental radiographs, laser fluorescence, fiber optic, and magnification. Results: 532 members responded. Overall, the dental explorer was the main tool for diagnosing primary occlusal caries. The percent of dentists who reported using it for all their patients ranged from 68% in AL/MS to 42% in SK to 29% in HP. For recurrent caries, these percentages ranged from 66% in AL/MS to 47% in PDA to 37% in HP. In contrast, laser fluorescence was rarely used except in the FL/GA region where 24% of the respondents used it for at least some of their patients. For proximal caries, the radiograph was the main tool with use ranging from 63% of FL/GA and PDA dentists to 21% of SK dentists using it for all their patients. Similarly, the percentage of dentists always using magnification ranged from 58% in FL/GA to 17% in SK. Conclusion: There is considerable variation in the techniques used for diagnosing caries across the DPBRN regions. Support: NIDCR-NIH U01-DE 16746 and 16747