Are Brazilian dentists and dental students using the ICCC recommendations for caries management? (original) (raw)
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Journal of Dental Health and Oral Research, 2023
Traditionally, caries has been addressed through surgical means, where the dentist utilizes rotary and hand instruments to eliminate the affected tooth tissue, creating a cavity that is subsequently filled with biomaterials for restoration purposes. This approach stems from the understanding of caries as an irreversible condition involving the destruction of hard tissues. However, recent evidence reveals caries to be a dynamic ailment characterized by alternating phases of demineralization and remineralization of hard tooth tissues. Contrary to the earlier perception, caries is now recognized as a dynamic disease with a fluctuating balance between factors that protect and promote tooth remineralization, as well as factors that contribute to tooth demineralization. Identified as caries risk factors and indicators, these pathological elements prompt a shift in perspective among cariologists towards managing caries through a medical model. In this medical model, caries is viewed as a multifactorial infectious disease caused by acidogenic bacteria present in the oral cavity. The recommended approach involves preventive strategies such as evaluating patients' caries risk, regulating bacterial levels in saliva, employing various therapeutic agents, remineralizing incipient carious lesions and ultimately restoring cavitated lesions. These strategies not only emphasize prevention but also align with the principles of Minimal Intervention Dentistry (MID). Dental students studying in various dental institutions receive theoretical education on existing preventive caries management; however, the practical application of this knowledge is insufficient and requires emphasis through integration into the curriculum.
Knowledge and opinions of French dental students in caries management
HAL (Le Centre pour la Communication Scientifique Directe), 2019
HAL is a multidisciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.
Cariology for the 21st Century: current caries management concepts for dental practice
The Journal of the Michigan Dental Association, 2013
The objective of this manuscript is to provide an overview of currently accepted, evidence-based and/or expert opinion recommendations for the prevention and management of dental caries in dental practice. Discussions are centered on current concepts for caries lesion detection (e.g., cavitated and non-cavitated lesions) and diagnosis (e.g., active vs. arrested lesions), including thresholds for non-surgical (e.g., fluorides, sealant) and surgical (i.e., restorative) interventions, risk assessment, and a review of caries management interventions for caries disease management. The goal is to prevent and manage the caries disease process using patient-centered, risk-based interventions supported by the best available evidence, taking into account the dentist's clinical expertise and the patient's treatment needs and preferences, in order to maintain or re-establish health and preserve tooth structure.
This review focuses on the clinical interactions between patients and the dental team, not on caries prevention at a public health level. Many dentists no longer take a narrow surgical view seeking to apply interventive treatment as a one-off event at a certain trigger point of disease severity and the evidence that caries is an initially reversible, chronic disease with a known multi-factorial aetiology is being appreciated more widely. The caries process should be managed over time in an individualized way for each patient. Very few individuals can be considered to be truly 'caries free' when initial lesions as well as more advanced dentine lesions are considered. It is now very clear that, by itself, restorative treatment of the disease does not 'cure' caries. The caries process needs to be managed, in partnership with patients, over the changing challenges of a lifetime. The answer to the question posed in the title should be, in many cases, that we are ready to move to non-operative/preventive care (if we have not done so already). However, this should be for appropriate stages of lesion extent and in patients who respond to advice on recall frequency and preventive behaviours.
Knowledge and Opinions of French Dental Students Toward Occlusal and Proximal Restorative Thresholds
HAL (Le Centre pour la Communication Scientifique Directe), 2021
HAL is a multidisciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.
Assessment of Dentists’ Knowledge Versus Their Practices Towards Treating Dental Caries
Owing to induction of modern technology in dentistry, advent of adhesive restorative materials and better understanding of caries and its prevention modalities, caries treatment has turn out to be less invasive and more effective. Despite having all of the options for caries management at hand, most of the dentistscontinue to treat caries by traditional drill & fill technique. This can be well observed in Middle Eastern countries where dentists of various nationalities, especially from Asian and African countriescome to work in health sector. This multinational study accomplished in Asian and African countries was done to assess the status of practicing dentists’ knowledge about the modern pathways for caries management and its implementation in their clinical practices. Therefore, the objectives of this study were to assess knowledge of practicing dentists about caries treatment and to assess percentage of the dentists following modern caries- treating strategies. Material & Methods: A meticulously prepared userfriendly questionnaire was displayed on social media consisting of 12 queries each on dentists’ knowledge about caries management and practice of its clinical implementation. Results: Dentists from many Asian and African countries participated in the study and 515 responses were received. The data was analyzed using SPSS 17. Conclusion: Most of the participating dentists lack pragmatic approach towards caries treatment despite having up-to-date pedagogic knowledge about caries management strategies
Evaluation of final-year dental students concerning therapeutic decision making for proximal caries
Brazilian Oral Research, 2009
This cross-sectional study aimed to determine the radiographic criteria used by fi nal-year dental students when defi ning the need for restorative treatment for proximal caries, as well as investigating potentially associated factors in this therapeutic decision. A questionnaire with two schematic diagrams presenting fi ve levels of proximal lesion penetration was administered to students attending the six private and three public dental schools in the state of Rio Grande do Sul, Southern Brazil. Absolute and relative frequencies were described and inferential statistics involving Chi-square and McNemar tests and simple logistic regression were carried out to assess variations in therapeutic decisions related to patient dentition (deciduous/permanent) and gender, age and dental school (public/private). Of the 346 dental students assessed, 28.6% (99/346) indicated restorative treatment for lesions restricted to the enamel in deciduous teeth and 38.2% (132/346) indicated the same for permanent teeth, revealing a statistically signifi cant difference (p = 0.001). Student gender and age were not associated with the therapeutic decision; however, a signifi cant difference between dental schools was found when comparing restorative criteria in deciduous (p < 0.001) and permanent molars (p < 0.001). The odds of restorative decision in permanent teeth when the caries lesion was restricted to the enamel was 72% higher for students graduating from private schools compared to public schools (Odds Ratio: 1.72; 95% Confi dence Interval: 1.03-2.90). These data demonstrate a large variation between the therapeutic decisions regarding proximal caries reported by fi nal-year dental students and suggest that deep refl ection is needed on the part of faculty in order to provide an evidence-based education.
Exploring How U.S. Dental Schools Teach Removal of Carious Tissues During Cavity Preparations
Journal of Dental Education, 2017
Approaches for managing carious tissues during cavity preparations vary considerably among clinicians, which may reflect inconsistencies in the teaching of this subject by dental schools. The aims of this study were to investigate practices related to the preclinical and clinical teaching of caries removal at U.S. dental schools and the relationship between that teaching and requirements for U.S. dental licensure examinations. The electronic survey included questions about terminology, methods, instruments and materials, treatment planning, criteria for clinical exams, faculty calibration sessions, and licensure exams. The faculty members at U.S. dental schools responsible for teaching cariology were invited to participate; 54 of the 65 schools had identified a contact person at the time of the survey in October 2015. Of those 54 invited to participate, 43 completed the survey (response rate of 79.6%). Most of the respondents indicated that depth of carious lesions was a clinical determinant of the amount of carious dentin being removed in cavity preparations. Caries removal was used as a criterion in restorative clinical examinations by 95% of responding schools. Marked differences were observed regarding the criteria used for assessment and removal of carious tissues, management of deep carious lesions, and definition of "caries remaining at cavity preparations," which is considered a critical error on licensure exams. Faculty calibration sessions on caries removal were reported to occur in 65% of these schools and at different time frames. Overall, the study found a wide range of teaching practices related to caries removal. Best evidence in caries management needs to be aligned with teaching and the criteria used to calibrate faculty members and examiners.