title: Methods dentists use to diagnose primary caries lesions prior to restorative treatment: Findings from The Dental PBRN.
abstract: OBJECTIVE
  To (1) quantify the diagnostic techniques used by Dental Practice-Based Research Network (DPBRN) dentists before they decide to treat primary caries lesions surgically and (2) examine whether certain dentist, practice, and patient characteristics are associated with their use.
  
  
  METHODS
  A total of 228 DPBRN dentists recorded information on 5,676 consecutive restorations inserted due to primary caries lesions on 3,751 patients. Practitioner-investigators placed a mean of 24.9 (SD = 12.4) restorations. Lesions were categorized as posterior proximal, anterior proximal, posterior occiusal, posterior smooth, or anterior smooth. Techniques used to diagnose the lesion were categorized as clinical assessment, radiographs, and/or optical. Statistical analysis utilized generalized mixed-model ANOVA to account for the hierarchical structure of the data.
  
  
  RESULTS
  By lesion category, the diagnostic technique combinations used most frequently were clinical assessment plus radiographs for posterior proximal (47%), clinical assessment for anterior proximal (51%), clinical assessment for posterior occlusal (46%), clinical assessment for posterior smooth (77%), and clinical assessment for anterior smooth (80%). Diagnostic technique was significantly associated with lesion category after adjusting for clustering in dentists (p < 0.0001).
  
  
  CONCLUSIONS
  These results--obtained during actual clinical procedures rather than from questionnaire-based hypothetical scenarios--quantified the diagnostic techniques most commonly used during the actual delivery of routine restorative care. Diagnostic technique varied by lesion category and with certain practice and patient characteristics.
authors.forename: Brad J D
authors.initials: BJ
authors.lastname: Rindal
authors.forename: Valeria V
authors.initials: VV
authors.lastname: Gordan
authors.forename: Mark S
authors.initials: MS
authors.lastname: Litaker
authors.forename: James D
authors.initials: JD
authors.lastname: Bader
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Fellows
authors.forename: Vibeke
authors.initials: V
authors.lastname: Qvist
authors.forename: Martha C
authors.initials: MC
authors.lastname: Wallace-Dawson
authors.forename: Mary L
authors.initials: ML
authors.lastname: Anderson
authors.forename: Gregg H
authors.initials: GH
authors.lastname: Gilbert