Methods dentists use to diagnose primary caries lesions prior to restorative treatment: findings from The Dental PBRN

TY - JOUR

T1 - Methods dentists use to diagnose primary caries lesions prior to restorative treatment: findings from The Dental PBRN

AU - Rindal, D Brad

AU - Gordan, Valeria V

AU - Litaker, Mark S

AU - Bader, James D

AU - Fellows, Jeffrey L

AU - Qvist, Vibeke

AU - Wallace-Dawson, Martha C

AU - Anderson, Mary L

AU - Gilbert, Gregg H

AU - DPBRN Collaborative Group

N1 - Copyright © 2010 Elsevier Ltd. All rights reserved.

PY - 2010/12/1

Y1 - 2010/12/1

N2 - Objective: To (1) quantify the diagnostic techniques used by Dental Practice-Based Research Network (DPBRN) dentists before they decide to treat primary caries lesions surgically and (2) examine whether certain dentist, practice, and patient characteristics are associated with their use. Methods: A total of 228 DPBRN dentists recorded information on 5676 consecutive restorations inserted due to primary caries lesions on 3751 patients. Practitioner-investigators placed a mean of 24.9 (SD = 12.4) restorations. Lesions were categorised as posterior proximal, anterior proximal, posterior occlusal, posterior smooth, or anterior smooth. Techniques used to diagnose the lesion were categorised as clinical assessment, radiographs, and/or optical. Statistical analysis utilised generalised mixed-model ANOVA to account for the hierarchical structure of the data. Results: By lesion category, the diagnostic technique combinations used most frequently were clinical assessment plus radiographs for posterior proximal (47%), clinical assessment for anterior proximal (51%), clinical assessment for posterior occlusal (46%), clinical assessment for posterior smooth (77%), and clinical assessment for anterior smooth (80%). Diagnostic technique was significantly associated with lesion category after adjusting for clustering in dentists (p < 0.0001). Conclusion: These results - obtained during actual clinical procedures rather than from questionnaire-based hypothetical scenarios - quantified the diagnostic techniques most commonly used during the actual delivery of routine restorative care. Diagnostic technique varied by lesion category and with certain practice and patient characteristics.

AB - Objective: To (1) quantify the diagnostic techniques used by Dental Practice-Based Research Network (DPBRN) dentists before they decide to treat primary caries lesions surgically and (2) examine whether certain dentist, practice, and patient characteristics are associated with their use. Methods: A total of 228 DPBRN dentists recorded information on 5676 consecutive restorations inserted due to primary caries lesions on 3751 patients. Practitioner-investigators placed a mean of 24.9 (SD = 12.4) restorations. Lesions were categorised as posterior proximal, anterior proximal, posterior occlusal, posterior smooth, or anterior smooth. Techniques used to diagnose the lesion were categorised as clinical assessment, radiographs, and/or optical. Statistical analysis utilised generalised mixed-model ANOVA to account for the hierarchical structure of the data. Results: By lesion category, the diagnostic technique combinations used most frequently were clinical assessment plus radiographs for posterior proximal (47%), clinical assessment for anterior proximal (51%), clinical assessment for posterior occlusal (46%), clinical assessment for posterior smooth (77%), and clinical assessment for anterior smooth (80%). Diagnostic technique was significantly associated with lesion category after adjusting for clustering in dentists (p < 0.0001). Conclusion: These results - obtained during actual clinical procedures rather than from questionnaire-based hypothetical scenarios - quantified the diagnostic techniques most commonly used during the actual delivery of routine restorative care. Diagnostic technique varied by lesion category and with certain practice and patient characteristics.

KW - Analysis of Variance

KW - Chi-Square Distribution

KW - Cross-Sectional Studies

KW - Dental Caries

KW - Dental Caries Activity Tests

KW - Dental Research

KW - Dentist's Practice Patterns

KW - Female

KW - Group Practice, Dental

KW - Humans

KW - Insurance, Dental

KW - Light

KW - Logistic Models

KW - Male

KW - Odds Ratio

KW - Private Practice

KW - Public Health Dentistry

KW - Questionnaires

KW - Radiography, Dental

KW - Transillumination

KW - United States

KW - Workload

U2 - 10.1016/j.jdent.2010.09.003

DO - 10.1016/j.jdent.2010.09.003

M3 - Journal article

C2 - 20884316

SN - 1687-8728

VL - 38

SP - 1027

EP - 1032

JO - International Journal of Dentistry

JF - International Journal of Dentistry

IS - 12

ER -