title: Exploring How U.S. Dental Schools Teach Removal of Carious Tissues During Cavity Preparations.
abstract: Approaches for managing carious tissues during cavity preparations vary considerably among clinicians, which may reflect inconsistencies in the teaching of this subject by dental schools. The aims of this study were to investigate practices related to the preclinical and clinical teaching of caries removal at U.S. dental schools and the relationship between that teaching and requirements for U.S. dental licensure examinations. The electronic survey included questions about terminology, methods, instruments and materials, treatment planning, criteria for clinical exams, faculty calibration sessions, and licensure exams. The faculty members at U.S. dental schools responsible for teaching cariology were invited to participate; 54 of the 65 schools had identified a contact person at the time of the survey in October 2015. Of those 54 invited to participate, 43 completed the survey (response rate of 79.6%). Most of the respondents indicated that depth of carious lesions was a clinical determinant of the amount of carious dentin being removed in cavity preparations. Caries removal was used as a criterion in restorative clinical examinations by 95% of responding schools. Marked differences were observed regarding the criteria used for assessment and removal of carious tissues, management of deep carious lesions, and definition of "caries remaining at cavity preparations," which is considered a critical error on licensure exams. Faculty calibration sessions on caries removal were reported to occur in 65% of these schools and at different time frames. Overall, the study found a wide range of teaching practices related to caries removal. Best evidence in caries management needs to be aligned with teaching and the criteria used to calibrate faculty members and examiners.
authors.affiliation: Dr. Nascimento is Associate Professor, Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, University of Florida; Dr. Behar-Horenstein is Distinguished Teaching Scholar and Professor, Colleges of Dentistry, Education, Veterinary Medicine, and Pharmacy, as well as being Director, CTSI Educational Development and Evaluation and Co-Director, HRSA Faculty Development in Dentistry, University of Florida; Ms. Feng is a doctoral candidate, School of Human Development and Organizational Studies in Education, College of Education, University of Florida; Dr. Guzmán-Armstrong is Clinical Associate Professor, Department of Operative Dentistry, University of Iowa College of Dentistry & Dental Clinics; and Dr. Fontana is Professor, Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan. mnascimento@dental.ufl.edu.
authors.forename: Marcelle M
authors.initials: MM
authors.lastname: Nascimento
authors.affiliation: Dr. Nascimento is Associate Professor, Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, University of Florida; Dr. Behar-Horenstein is Distinguished Teaching Scholar and Professor, Colleges of Dentistry, Education, Veterinary Medicine, and Pharmacy, as well as being Director, CTSI Educational Development and Evaluation and Co-Director, HRSA Faculty Development in Dentistry, University of Florida; Ms. Feng is a doctoral candidate, School of Human Development and Organizational Studies in Education, College of Education, University of Florida; Dr. Guzmán-Armstrong is Clinical Associate Professor, Department of Operative Dentistry, University of Iowa College of Dentistry & Dental Clinics; and Dr. Fontana is Professor, Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan.
authors.forename: Linda S
authors.initials: LS
authors.lastname: Behar-Horenstein
authors.affiliation: Dr. Nascimento is Associate Professor, Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, University of Florida; Dr. Behar-Horenstein is Distinguished Teaching Scholar and Professor, Colleges of Dentistry, Education, Veterinary Medicine, and Pharmacy, as well as being Director, CTSI Educational Development and Evaluation and Co-Director, HRSA Faculty Development in Dentistry, University of Florida; Ms. Feng is a doctoral candidate, School of Human Development and Organizational Studies in Education, College of Education, University of Florida; Dr. Guzmán-Armstrong is Clinical Associate Professor, Department of Operative Dentistry, University of Iowa College of Dentistry & Dental Clinics; and Dr. Fontana is Professor, Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan.
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Feng
authors.affiliation: Dr. Nascimento is Associate Professor, Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, University of Florida; Dr. Behar-Horenstein is Distinguished Teaching Scholar and Professor, Colleges of Dentistry, Education, Veterinary Medicine, and Pharmacy, as well as being Director, CTSI Educational Development and Evaluation and Co-Director, HRSA Faculty Development in Dentistry, University of Florida; Ms. Feng is a doctoral candidate, School of Human Development and Organizational Studies in Education, College of Education, University of Florida; Dr. Guzmán-Armstrong is Clinical Associate Professor, Department of Operative Dentistry, University of Iowa College of Dentistry & Dental Clinics; and Dr. Fontana is Professor, Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan.
authors.forename: Sandra
authors.initials: S
authors.lastname: Guzmán-Armstrong
authors.affiliation: Dr. Nascimento is Associate Professor, Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, University of Florida; Dr. Behar-Horenstein is Distinguished Teaching Scholar and Professor, Colleges of Dentistry, Education, Veterinary Medicine, and Pharmacy, as well as being Director, CTSI Educational Development and Evaluation and Co-Director, HRSA Faculty Development in Dentistry, University of Florida; Ms. Feng is a doctoral candidate, School of Human Development and Organizational Studies in Education, College of Education, University of Florida; Dr. Guzmán-Armstrong is Clinical Associate Professor, Department of Operative Dentistry, University of Iowa College of Dentistry & Dental Clinics; and Dr. Fontana is Professor, Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan.
authors.forename: Margherita
authors.initials: M
authors.lastname: Fontana
mesh_terms: D003731:Dental Caries / Q000601:surgery; D003737:Dental Cavity Preparation / Q000379:methods*; D006801:Humans; D012575:Schools, Dental / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013663:Teaching / Q000706:statistics & numerical data*; D014481:United States
keywords: caries management; caries removal; cariology; dental caries; dental education