An investigation into the management of the deep carious lesion by general dental practitioners in the UK

Objectives As techniques and dental materials have evolved, the management of deep carious lesions has also changed. This study investigated how UK-based general dental practitioners (GDPs) managed deep carious lesions in permanent, vital teeth and factors that influence their choices. Methods This mixed-method study employed an online questionnaire as its primary source of quantitative data collection. The questionnaire enquired about GDPs': a) demographics; b) working environment; and c) whether they had postgraduate training that covered caries management/minimally invasive dentistry (MID). Respondents were presented with a clinical case to elicit qualitative data. Relevant questions were asked in order to examine current practice and explore treatment among the respondents. Results In total, 239 responses were received. Overall, 168 (70% [95% CI 64%, 76%]) of the respondents chose a partial caries removal technique, 155 (69.3% [95% CI 60%, 72%]) used an adhesive restorative material and 205 (85.8% [95% CI 81%, 89%]) advised fluoride adjuncts. However, rubber dam (75; 31.4% [95% CI 26%, 38%]) and saliva testing (17; 7.1% [95% CI 4%, 11%]) were not routinely used. A significant relationship between those who had postgraduate training and those who chose partial caries removal as their treatment choice (χ 2 = 6.27; p = 0.01) was noted. Respondents working in an NHS-based practice were significantly (χ 2 = 34.98; p <0.001) more likely to restore teeth with amalgam. Conclusions There is an inconsistent management protocol when presented with a deep carious lesion, but partial caries removal is more widely adopted than previously reported. Rubber dam isolation was not routinely used when choosing to restore a deep carious lesion. Those who have had postgraduate training felt more confident in offering MID, so there is a clear need for further education to ensure its engagement.