Decision Making on Caries Management in Children and Adolescents Among Thai Dentists

The International Caries Classification and Management System (ICCMS) advocates for nonsurgical approaches in early carious lesions and minimally invasive restorations in advanced cases.

This study investigated Thai dentists' adherence to ICCMS guidelines for managing caries in children and adolescents and explored factors influencing their decisions.

A web-based questionnaire collected demographic information and routine treatment preferences for various stages of carious lesions from participants. Descriptive statistics and regression analyses were employed to examine relationships between management strategies and demographics.

A total of 442 dentists participated. Their agreement with ICCMS guidelines for occlusal caries ICDAS 2, 3, and 4 in primary dentition was 39.6%, 53.9%, and 42.5%, respectively, and in permanent dentition was 34.4%, 46.8%, and 39.6%, respectively. The agreement rate with ICCMS guidelines for approximal caries RA1, RA2, RA3, and RB4 in primary dentition was 69.6%, 78.0%, 12.4%, and 99.5%, respectively, and in permanent dentition was 70.8%, 68.3%, 19.0%, and 97.7%, respectively. Factors associated with restorative treatment decisions included years since graduation, postgraduate education, and practice type.

Participants did not comply well with ICCMS recommendations for occlusal caries, some employed destructive techniques instead of noninvasive approaches. However, most participants followed ICCMS guidelines for approximal caries, except for RA3 stage.