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Dentists’ attitudes and behaviour regarding deep carious lesion management: a multi-national survey

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Abstract

Objectives

The present study aimed, using a questionnaire, to assess and compare behaviour, attitudes and beliefs of French, German and Norwegian dentists regarding deep carious lesion management.

Materials and methods

A mail survey was applied to simple random national samples of dentists. Descriptive analysis and logistic regression analysis were performed.

Results

Sample size was 661 (response rate, 33 %) in France, 622 (25 %) in Germany and 199 (33 %) in Norway. Hardness was the criterion used most often for assessing carious tissue removal in all three countries (>95 %), with most dentists aiming for only hard dentine remaining at the pulpal wall (>66 %); dentine colour was not found relevant by most respondents. The majority of French and German practitioners (>66 %) would perform complete excavation even for deep lesions, while most Norwegian dentists (84 %) opted for stepwise excavation. Most dentists thought complete removal was required to avoid lesion progression and were uncertain if remaining sealed bacteria would harm the pulp. Treatment decisions were guided by prior experience and familiarity. For example, stepwise removal was performed less often by dentists who were male, French, German or those in the private sector.

Conclusions

Less invasive strategies for managing deep lesions have not widely entered clinical practice in France and Germany. Underlying beliefs shape decision-making.

Clinical relevance

The present study is the first of its nature to analyse and compare deep carious lesion management between three European countries. It shows that there is an urgent need to practically educate dentists in less invasive strategies.

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Acknowledgments

The authors would like to thank Pr HM Eriksen for his kind cooperation in translating the Norwegian questionnaire.

Author information

Authors and Affiliations

  1. Department of Operative and Preventive Dentistry, Charite – Universitätsmedizin Berlin, Campus Benjamin Franklin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany

    Falk Schwendicke & Karim Elhennawy

  2. Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Postboks 6050 Langnes, 9037, Tromsø, Norway

    Lina Stangvaltaite, Isabel Eriksen, Tone Christiansen Kuzmiszyn & Eero Kerosuo

  3. Aide Odontologique Internationale, 1 Rue Maurice Arnoux, 92120, Montrouge, France

    Christopher Holmgren

  4. Department of Social and Preventive Dentistry, Faculty of Odontology, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos 2492, Porto Alegre, RS, 90035-003, Brazil

    Marisa Maltz

  5. CHU Clermont-Ferrand, Service d’Odontologie, Hôtel-Dieu, F-63001 Clermont-Ferrand, France. Univ Clermont1, UFR d’Odontologie, Centre de Recherche en Odontologie Clinique EA 4847, F-63100 Clermont-Ferrand, France, 2 rue de Braga, 63100, Clermont-Ferrand, France

    Marion Finet & Sophie Doméjean

Authors
  1. Falk Schwendicke
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  2. Lina Stangvaltaite
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  3. Christopher Holmgren
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  4. Marisa Maltz
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  5. Marion Finet
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  6. Karim Elhennawy
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  7. Isabel Eriksen
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  8. Tone Christiansen Kuzmiszyn
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  9. Eero Kerosuo
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  10. Sophie Doméjean
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Corresponding author

Correspondence to Sophie Doméjean.

Ethics declarations

This study was ethically approved: in France: registration by the Comité National Informatique et Liberté (CNIL) board (# 0104) and the Direction de la Recherche Clinique et de l’Innovation (DRCI) of Clermont-Ferrand university hospital; in Germany: ethics board of the Charité–Universitätsmedizin Berlin (EA2/137/14); in Norway: ethical approval was considered unnecessary by the Regional Ethical Committee of Northern Norway and Data Protection Official for Research has assessed the study as not being subject to notification.

Funding

The study was funded by the authors and their institutions.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Not applicable

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Schwendicke, F., Stangvaltaite, L., Holmgren, C. et al. Dentists’ attitudes and behaviour regarding deep carious lesion management: a multi-national survey. Clin Oral Invest 21, 191–198 (2017). https://doi.org/10.1007/s00784-016-1776-5

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  • DOI: https://doi.org/10.1007/s00784-016-1776-5

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