Download PDF
CC BY-NC-ND 4.0 · Eur J Dent 2018; 12(02): 300-304
DOI: 10.4103/ejd.ejd_397_17
Original Article
European Journal of Dentistry

Management preferences of deep caries in permanent teeth among dentists in Saudi Arabia

Taleb Hussain Alnahwi
1   College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
,
Mostafa Alhamad
2   Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
,
Abdul Majeed
2   Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
,
Muhammad Ashraf Nazir
3   Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
› Author Affiliations
Further Information

Publication History

Publication Date:
16 September 2019 (online)

   Permissions and Reprints

ABSTRACT

Objective: To report the management preferences of deep caries in permanent teeth among dentists. Materials and Methods: This observational cross-sectional study included a convenience sample of 177 dentists selected from private and public dental clinics in different cities of the Eastern Province of Saudi Arabia. Four clinical scenarios about the absence or presence of pain/symptoms and the risk of pulp exposure in deep caries were presented to the dentists in a pilot-tested questionnaire. Results: Most dentists (82.5%) preferred complete caries excavation when there was no risk of pulp exposure and no pain/symptom was associated with deep caries in permanent teeth. The stepwise technique was the procedure of choice reported by 57.8% of dentists when there was no pain but a risk of exposure was present. In case of no exposure risk but the presence of nonspontaneous pain (pain on thermal testing), complete caries removal was chosen by 55.9% of the respondents. Root canal treatment and stepwise caries removal were preferred by 42.4% and 38.4%, respectively, when there was a risk of exposure and nonspontaneous pain. The risk of exposure (81.4%), the progression of caries (73.4%), and treatment failure (58.8%) were the most common concerns with different caries removal techniques. The hardness was the most commonly used criterion (85.3%) followed by the color of caries (50.3%) during caries excavation. Conclusions: The majority of dentists preferred to completely remove caries in case of no risk of pulp exposure. The dentists should update their knowledge and adopt latest concepts about minimally invasive caries removal approaches.

Key words:

Deep caries - partial caries removal - stepwise caries removal - total caries removal
 

  • REFERENCES

  • 1 Schwendicke F, Meyer-Lueckel H, Dörfer C, Paris S. Attitudes and behaviour regarding deep dentin caries removal: A survey among german dentists. Caries Res 2013; 47: 566-73
    CrossrefPubMedGoogle Scholar
  • 2 Hayashi M, Fujitani M, Yamaki C, Momoi Y. Ways of enhancing pulp preservation by stepwise excavation – A systematic review. J Dent 2011; 39: 95-107
    CrossrefPubMedGoogle Scholar
  • 3 Mattos J, Soares GM, Ribeiro Ade A. Current status of conservative treatment of deep carious lesions. Dent Update 2014; 41: 452-454 , 456
    CrossrefPubMedGoogle Scholar
  • 4 Thompson V, Craig RG, Curro FA, Green WS, Ship JA. Treatment of deep carious lesions by complete excavation or partial removal: A critical review. J Am Dent Assoc 2008; 139: 705-12
    CrossrefPubMedGoogle Scholar
  • 5 Orhan AI, Oz FT, Orhan K. Pulp exposure occurrence and outcomes after 1- or 2-visit indirect pulp therapy vs. complete caries removal in primary and permanent molars. Pediatr Dent 2010; 32: 347-55
    PubMedGoogle Scholar
  • 6 Ricketts DN, Kidd EA, Innes N, Clarkson J. Complete or ultraconservative removal of decayed tissue in unfilled teeth. Cochrane Database Syst Rev 2006; (00) CD003808 DOI: 10.1002/14651858.CD000247.pub2.
    CrossrefPubMedGoogle Scholar
  • 7 Ricketts D, Lamont T, Innes NP, Kidd E, Clarkson JE. Operative caries management in adults and children. Cochrane Database Syst Rev (00) 2013; CD003808 DOI: 10.1002/14651858.CD000247.pub2.
    CrossrefPubMedGoogle Scholar
  • 8 Leksell E, Ridell K, Cvek M, Mejàre I. Pulp exposure after stepwise versus direct complete excavation of deep carious lesions in young posterior permanent teeth. Endod Dent Traumatol 1996; 12: 192-6
    CrossrefPubMedGoogle Scholar
  • 9 Bjørndal L, Reit C, Bruun G, Markvart M, Kjaeldgaard M, Näsman P. et al. Treatment of deep caries lesions in adults: Randomized clinical trials comparing stepwise vs. direct complete excavation, and direct pulp capping vs. partial pulpotomy. Eur J Oral Sci 2010; 118: 290-7
    PubMedGoogle Scholar
  • 10 Schwendicke F, Dörfer CE, Paris S. Incomplete caries removal: A systematic review and meta-analysis. J Dent Res 2013; 92: 306-14
    CrossrefPubMedGoogle Scholar
  • 11 Maltz M, Garcia R, Jardim JJ, de Paula LM, Yamaguti PM, Moura MS. et al. Randomized trial of partial vs stepwise caries removal: 3-year follow-up. J Dent Res 2012; 91: 1026-31
    Google Scholar
  • 12 Schwendicke F, Göstemeyer G. Understanding dentists' management of deep carious lesions in permanent teeth: A systematic review and meta-analysis. Implement Sci 2016; 11: 142
    CrossrefPubMedGoogle Scholar
  • 13 Bergenholtz G, Axelsson S, Davidson T, Frisk F, Hakeberg M, Kvist T. et al. Treatment of pulps in teeth affected by deep caries – A systematic review of the literature. Singapore Dent J 2013; 34: 1-2
    CrossrefPubMedGoogle Scholar
  • 14 Weber CM, Alves LS, Maltz M. Treatment decisions for deep carious lesions in the public health service in Southern Brazil. J Public Health Dent 2011; 71: 265-70
    CrossrefPubMedGoogle Scholar
  • 15 Stangvaltaite L, Kundzina R, Eriksen HM, Kerosuo E. Treatment preferences of deep carious lesions in mature teeth: Questionnaire study among dentists in Northern Norway. Acta Odontol Scand 2013; 71: 1532-7
    CrossrefPubMedGoogle Scholar
  • 16 Oen KT, Thompson VP, Vena D, Caufield PW, Curro F, Dasanayake A. et al. Attitudes and expectations of treating deep caries: A PEARL network survey. Gen Dent 2007; 55: 197-203
    PubMedGoogle Scholar
  • 17 Koopaeei MM, Inglehart MR, McDonald N, Fontana M. General dentists', pediatric dentists', and endodontists' diagnostic assessment and treatment strategies for deep carious lesions: A comparative analysis. J Am Dent Assoc 2017; 148: 64-74
    CrossrefPubMedGoogle Scholar
  • 18 Schwendicke F, Stangvaltaite L, Holmgren C, Maltz M, Finet M, Elhennawy K. et al. Dentists' attitudes and behaviour regarding deep carious lesion management: A multi-national survey. Clin Oral Investig 2017; 21: 191-8
    CrossrefPubMedGoogle Scholar
  • 19 Van Teijlingen E, Hundley V. The importance of pilot studies. Soc Res Update 2010; 35: 49-59
    Google Scholar
  • 20 Villat C, Attal JP, Brulat N, Decup F, Doméjean S, Dursun E. et al. One-step partial or complete caries removal and bonding with antibacterial or traditional self-etch adhesives: Study protocol for a randomized controlled trial. Trials 2016; 17: 404
    CrossrefPubMedGoogle Scholar
  • 21 Katz CR, de Andrade Mdo R, Lira SS, Ramos Vieira EL, Heimer MV. The concepts of minimally invasive dentistry and its impact on clinical practice: A survey with a group of Brazilian professionals. Int Dent J 2013; 63: 85-90
    CrossrefPubMedGoogle Scholar
  • 22 Shah AH, Sheddi FM, Alharqan MS, Khawja SG, Vohra F, Akram Z. et al. Knowledge and attitude among general dental practitioners towards minimally invasive dentistry in Riyadh and AlKharj. J Clin Diagn Res 2016; 10: ZC90-4
    CrossrefPubMedGoogle Scholar