title: Treatment of caries in relation to lesion severity: implications for minimum intervention dentistry.
abstract: OBJECTIVE
  To date there is little evidence of minimum intervention in relation to treatment patterns, particularly for initial carious lesions. The objective of this study was to investigate treatment provided to patients with a main diagnosis of coronal caries in relation to the severity of the caries lesion.
  
  
  METHODS
  A random sample of Australian dentists was surveyed by mailed questionnaires in 2009-2010 (response rate 67%). Data on services, patient characteristics and main diagnosis were collected from a service log.
  
  
  RESULTS
  Models of service rates adjusted for age, sex, insurance status and reason for visit showed that compared to the reference category of gross caries lesions, there were higher rates [rate ratio, 95% CI] of restorative services for initial [1.63, 1.31-2.03] and cavitated [1.69, 1.39-2.05] lesions, higher rates of prophylaxis for initial [3.77, 2.09-6.79] and cavitated [3.88, 2.29-6.58] lesions, lower rates of endodontic services for initial [0.07, 0.02-0.30] and cavitated [0.11, 0.04-0.30] lesions, and lower rates of extraction for initial [0.15, 0.06-0.34] and cavitated [0.15, 0.07-0.31] lesions.
  
  
  CONCLUSIONS
  Treatment of coronal caries was characterized by high rates of restorative services, but gross lesions had lower restorative rates and higher rates of endodontic and extraction services. There was little differentiation in treatment of coronal caries between initial and cavitated lesions, suggesting scope for increased management of initial carious lesions by the adoption of more minimum intervention approaches.
authors.affiliation: Australian Research Centre for Population Oral Health School of Dentistry, Faculty of Health Sciences, The University of Adelaide, 122 Frome Street, Adelaide 5005, SA, Australia. Electronic address: david.brennan@adelaide.edu.au.
authors.forename: D S
authors.initials: DS
authors.lastname: Brennan
authors.affiliation: Australian Research Centre for Population Oral Health School of Dentistry, Faculty of Health Sciences, The University of Adelaide, 122 Frome Street, Adelaide 5005, SA, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Balasubramanian
authors.affiliation: Australian Research Centre for Population Oral Health School of Dentistry, Faculty of Health Sciences, The University of Adelaide, 122 Frome Street, Adelaide 5005, SA, Australia.
authors.forename: A J
authors.initials: AJ
authors.lastname: Spencer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003731:Dental Caries / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D003793:Dental Restoration, Permanent; D003813:Dentistry / Q000379:methods; D005260:Female; D005792:General Practice, Dental; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011795:Surveys and Questionnaires; D019553:Tooth, Nonvital / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*
keywords: Dental service provision; Minimum intervention dentistry; Private general practice; Restorative services