Prevalence of Questionable Occlusal Caries Lesions

Although the progression of cavitated dental caries has slowed dramatically over the years, the prevalence of precavitated lesions has significantly increased; therefore, diagnosing these lesions has become an important part of daily clinical practice. Due to the size of these lesions, the ability to correctly diagnose and treat them can be difficult. There has been some debate on the best way to manage and treat these small lesions. Some clinicians believe it is best to perform operative treatment and conserve tooth structure; whereas, other clinicians believe in managing it with preventive treatment, allowing the lesion the potential to remineralize or arrest. Limited literature is available for these “questionable” lesions and the reasons behind why clinicians are having difficulty diagnosing and treating them.

The aims of this study are to (1) quantify the prevalence of questionable occlusal carious lesions in permanent teeth in the first 100 consecutive eligible patients of DPBRN practitioner-investigators; (2a) for unopened questionable occlusal carious lesions, to test the hypothesis that the patient’s baseline caries risk is significantly associated with lesion description (i.e., perceived caries status); and (2b) for opened questionable occlusal carious lesions, to test the hypothesis that the patient’s baseline caries risk is significantly associated with caries depth.

These aims will be met by enrolling 80-100 practitioner-investigators, each of whom will record information about 100 consecutive patients and 25-50 consecutive questionable early occlusal caries lesions on a 2-page questionnaire. The study will record the reason why these occlusal lesions were questionable, the tools used to diagnose the lesions, the reason why a certain treatment was rendered, and the depth of the lesions when treated operatively.

This study about early occlusal caries lesions will provide the opportunity to compare these results to DPBRN study entitled “Assessment of Caries Diagnosis and Caries Treatment”, a questionnaire wherein practitioners’ caries diagnosis, caries treatment, and preventive dentistry practices were quantified as well as compare these results to the DPBRN study entitled “Longitudinal Study of Questionable Occlusal Carious Lesions”.