Will modern caries management reduce restorations in dental practice?
Dentists have difficulty diagnosing caries presence and activity. Modern caries management suggests that lesions in low risk patients should not be restored until the radiolucency extends into the outer third of interproximal dentin. Even stained fissures need not be restored in the absence of occlusal dentin radiolucency. If this standard were adopted, what affect would it have on the amount of operative treatment delivered? This report created a model to forecast the change in work volume caused by new caries management strategies. The model considered two identical groups of 1,000 adult teeth with a normal distribution of 1,000 radiographic lesions in each group. Group I would have all lesions restored at baseline, but Group II would have only lesions in the dentin restored. Each year for ten years the model forecasts the number of replacement restorations for both groups, plus initial restorations for Group II. A sensitivity analysis was conducted using slow progression rates (Group IIa) and fast progression rates (Group IIb). After ten years, Group IIa has 49% and Group IIb had 32% fewer restorations than Group I. It is concluded that the model is robust and modern caries management may significantly reduce operative workload.
Department of Oral Diagnostic Sciences, University of Florida College of Dentistry, Gainesville 32610-0414, USA.
D K
DK
Benn
M I
MI
Meltzer
D000328:Adult; D003731:Dental Caries / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D003750:Dental Fissures / Q000000981:diagnostic imaging / Q000473:pathology; D003793:Dental Restoration, Permanent / Q000379:methods* / Q000706:statistics & numerical data; D003804:Dentin / Q000000981:diagnostic imaging / Q000473:pathology; D018450:Disease Progression; D005544:Forecasting; D006801:Humans; D015233:Models, Statistical; D011859:Radiography; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014075:Tooth Discoloration / Q000473:pathology