Methods dentists use to diagnose primary caries lesions prior to restorative treatment: Findings from The Dental PBRN

Objective To (1) quantify the diagnostic techniques used by Dental Practice Based Research Network (DPBRN) dentists before they decide to treat primary canes lesions surgically and (2) examine whether certain dentist practice and patient characteristics are associated with their use Methods A total of 228 DPBRN dentists recorded information on 5676 consecutive restorations inserted due to primary canes lesions on 3751 patients Practitioner investigators placed a mean of 24 9 (SD = 12 4) restorations Lesions were categorised as posterior proximal anterior proximal posterior occlusal posterior smooth or anterior smooth Techniques used to diagnose the lesion were categorised as clinical assessment, radiographs, and/or optical Statistical analysis utilised generalised mixed model ANOVA to account for the hierarchical structure of the data Results By lesion category the diagnostic technique combinations used most frequently were clinical assessment plus radiographs for posterior proximal (47%) clinical assessment for anterior proximal (51%) clinical assessment for posterior occlusal (46%) clinical assessment for posterior smooth (77%) and clinical assessment for anterior smooth (80%) Diagnostic technique was significantly associated with lesion category after adjusting for clustering in dentists (p < 0 0001) Conclusion These results - obtained during actual clinical procedures rather than from questionnaire based hypothetical scenarios - quantified the diagnostic techniques most commonly used during the actual delivery of routine restorative care Diagnostic technique varied by lesion category and with certain practice and patient characteristics (C) 2010 Elsevier Ltd All rights reserved