ABSTRACT
Objective: To report the management preferences of deep caries in permanent teeth among dentists.
Materials and Methods: This observational cross-sectional study included a convenience sample of 177 dentists
selected from private and public dental clinics in different cities of the Eastern
Province of Saudi Arabia. Four clinical scenarios about the absence or presence of
pain/symptoms and the risk of pulp exposure in deep caries were presented to the dentists
in a pilot-tested questionnaire. Results: Most dentists (82.5%) preferred complete caries excavation when there was no risk
of pulp exposure and no pain/symptom was associated with deep caries in permanent
teeth. The stepwise technique was the procedure of choice reported by 57.8% of dentists
when there was no pain but a risk of exposure was present. In case of no exposure
risk but the presence of nonspontaneous pain (pain on thermal testing), complete caries
removal was chosen by 55.9% of the respondents. Root canal treatment and stepwise
caries removal were preferred by 42.4% and 38.4%, respectively, when there was a risk
of exposure and nonspontaneous pain. The risk of exposure (81.4%), the progression
of caries (73.4%), and treatment failure (58.8%) were the most common concerns with
different caries removal techniques. The hardness was the most commonly used criterion
(85.3%) followed by the color of caries (50.3%) during caries excavation. Conclusions: The majority of dentists preferred to completely remove caries in case of no risk
of pulp exposure. The dentists should update their knowledge and adopt latest concepts
about minimally invasive caries removal approaches.
Key words:
Deep caries - partial caries removal - stepwise caries removal - total caries removal
