Changes in Treatment of Suspicious-Occlusal-Caries Lesions: Results From National-Dental-PRBN

Objectives: This study examined the impact of attending a National Dental Practice-based Research Network (http://nationaldentalpbrn.org/) meeting on practitioners’ treatment decisions for suspicious occlusal caries lesions (SOCL).
Methods: Initially, the 150 participating practitioners completed a short questionnaire about practice characteristics, their viewpoints on useful cues (color, luster, tooth type and locations, feel of lesion, and patient risk) in the diagnosis of SOCL, and clinical case scenarios (vignettes) of SOCL patients. For each vignette, practitioners selected the severity and depth of the lesion at which point they would perform surgical treatment. Practitioners then attended a 20-minute presentation that described findings from a network study detailing how network dentists assessed and treated SOCL. Then they participated in a 45-minute small group breakout discussion and a panel discussion led by table leaders. Concluding with a follow-up questionnaire that repeated the initial questions about SOCL cues and clinical scenarios.
Results: Results showed a shift in the choice of most-useful cues with an increased selection of caries risk and corresponding decrease in the importance of the feel of the lesion with a probe/explorer. There was little change in the importance of color. Tooth type and location in the arch were seldom chosen as useful cues. In both the high-and low-risk patient scenarios, following the SOCL presentation and discussion, a significant shift (p < .001) occurred towards delaying surgical treatment to a deeper lesion depth. There was also a significant change towards no difference in the probability of surgical intervention after the discussion regarding the use of a SOCL diagnostic device (p = .028).
Conclusions: This study demonstrated that dissemination of research findings to practitioners in a Network meeting has the potential to affect practitioners’ intention to treat SOCL. Support: NIH/NIDCR-U19-DE-22516.