Brazilian dentists' restorative treatment decisions

To investigate the pattern of decision-making by southern Brazilian dentists regarding the use of restorations in the treatment of dental caries.

A cross-sectional survey involving 840 dentists, randomly selected in three southern Brazilian states, was performed. Telephone interviews were conducted by three previously trained dentists, in which clinical situations with different-depth radiolucencies, based upon bitewing radiographs, were described. Two other situations, including dark fissures and white spots, were also described. The main outcome measures were the tendency in clinical decision-making in comparison with the number of years elapsed since qualification and attendance on postgraduate courses.

The overall response rate was 89.4%: 31.5% of dentists would restore cavities in the outer half of the enamel; 54.5% when the cavity reached the inner half of the enamel, but not the enamel-dentine junction (EDJ); 79.0% when cavities reached the EDJ; and 96.9% when cavities reached the outer half of the dentine. Furthermore, 21.8% of dentists would restore dark fissures without signs of demineralization. Dentists qualified for less than 10 years and those who had attended postgraduate courses were less interventionist.

It was concluded that dentists have an interventionist attitude in the making of treatment decisions for dental caries and may be over-treating in several situations.