Lithuanian Dental Students' Approach to Managing Deep Caries Lesions

The present study aimed to evaluate the management approaches to deep caries among dental undergraduate students in Lithuania and to examine the associated demographic factors.

Out of 318 fourth- and fifth-year dental students from the only two universities in Lithuania offering dental education, Vilnius University (VU) and the Lithuanian University of Health Sciences (LSMU), 155 students (response rate 48.7%) completed a previously used questionnaire. Both Lithuanian and international students were included. The questionnaire inquired about the management approaches of deep caries lesions when the tooth was asymptomatic or symptomatic (with signs and symptoms indicating of no worse than reversible pulpitis), with or without pulp exposure during caries removal, in a mature permanent tooth. Bivariate and multivariable statistical analyses were performed.

For deep caries lesions with no symptoms and no pulp exposure during caries removal, 60% (87) of respondents chose selective caries removal, whereas for symptomatic cases, 56% (83) preferred non-selective removal. For deep caries with no symptoms and with pulp exposure during caries removal, 64% (96) opted for direct pulp capping, mainly choosing mineral trioxide aggregate as capping material. In symptomatic cases, 38% (56) chose endodontic treatment and 32% (47) chose partial pulpotomy. International students were five times more likely to choose non-selective caries removal for deep caries with no symptoms and without pulp exposure during caries treatment (OR 4.98; CI: 2.24-11.57), had higher odds of choosing non-selective methods in deep caries with symptoms (OR 2.54; 95% CI: 1.14-5.91) and endodontic treatment in cases of pulp exposure during caries removal regardless of the presence of symptoms (OR 2.96; 95% CI: 1.36-6.61 for asymptomatic and OR 3.47; 95% CI: 1.29-10.15 for symptomatic cases). In deep caries with symptoms, VU students (OR 3.33; 95% CI: 1.58-7.18) and women (OR 2.58; 95% CI: 1.11-6.28) were more likely to choose non-selective methods.

Dental students in Lithuania applied evidence-based recommendations for managing deep caries lesions. However, when symptoms indicating reversible pulpitis were presented, a tendency to prefer more invasive treatments was observed. Universities in Lithuania should continue evidence-based teaching emphasising the regenerative capabilities of the pulp. In addition, providing a deeper understanding of pulp pathophysiology, highlighting that symptoms do not always indicate severe pathology, reinforcing aseptic techniques in clinical training and integrating case discussions between Lithuanian and international students could further improve the evidence-based curriculum.