Management of initial carious lesions: Iowa survey

Area of Science:

• Dental Public Health
• Caries Management
• Evidence-Based Dentistry

Background:

• The International Caries Classification and Management System (ICCMS) provides guidelines for managing initial carious lesions.
• Understanding dentists' adherence to evidence-based guidelines is crucial for effective caries management.
• Patient caries risk level is a key factor in determining appropriate treatment strategies.

Purpose of the Study:

• To assess Iowa dentists' agreement with the ICCMS for nonsurgical management of initial carious lesions.
• To identify factors associated with dentists' agreement with ICCMS guidelines across different patient caries risk levels.
• To explore the relationship between practice characteristics and adherence to evidence-based caries management.

Main Methods:

• Electronic surveys were distributed to 916 practicing Iowa dentists.
• Clinical scenarios with text, images, and radiographs were used to assess treatment recommendations.
• Logistic regression analysis examined associations between dentist characteristics, practice settings, caries risk, and ICCMS agreement.

Main Results:

• 138 dentists responded, with agreement rates of 73% (low risk), 59% (moderate risk), and 51% (high risk) for nonsurgical management.
• Dentists agreeing with ICCMS were more likely to use tooth drying, magnification, and perform caries risk assessments.
• Recent graduates (<20 years) and those in public health settings showed higher agreement with ICCMS guidelines.

Conclusions:

• Specific practices, including thorough caries detection methods and risk assessment, correlate with adherence to ICCMS guidelines.
• Factors such as recent graduation and public health practice settings are associated with greater agreement.
• Personalized, evidence-based management of initial caries lesions based on patient risk is essential.