Decision-Making for Occlusal Caries Lesions in Permanent Molars Reported by Dentists from a Brazilian Community

Abstract

Objective: To examine dentists' thresholds for restorative treatment for occlusal caries lesions in permanent molars, as a function of the patient's caries risk (PCR), and determine whether an "evidence-practice gap" (EPG) exists. Material and Methods: A convenience sample of dentists from a Brazilian community (n = 215) completed a questionnaire about their practice/patient characteristics, as well as a translated version of the "Assessment of Caries Diagnosis and Caries Treatment" Questionnaire. Dentists were presented with three clinical cases: Case 1, characterized by white discoloration in the outer enamel; Case 2, featuring brown discoloration in the inner enamel; and Case 3, presenting brown discoloration without cavitation in the outer third of the dentin. Two clinical scenarios were considered: low caries risk (LR) or increased caries risk. Results: An EPG was evident, as 57% of dentists would intervene operatively in the LR scenario, even when the lesion was still in the enamel. Dentists in private practice, those with a higher percentage of patients uninterested in individualized caries prevention, or those who graduated from a private dental school were more likely to perform operative treatment (p < .05). Conversely, dentists with an advanced degree or those who were female had a lower probability of performing operative treatment (p < .05). Conclusion: A substantial EPG was evident, the threshold for restorative treatment for occlusal caries progression was associated with dentists' professional context and educational background.