Clinical decision-making in managing deep carious lesions in primary teeth based on clinical experience among pediatric dentists-A cross-sectional study.

Abstract

Objective: To explore the different treatment methods employed in managing deep carious lesions (DCL) of vital primary teeth among pediatric dentists practic.ing in Saudi Arabia. We also want to find out whether the experience of pediatric dentists has any influence on clinical decision-making in managing DCL in primary teeth.

Methods: This online questionnaire-based cross-sectional study was carried out among pediatric dentists practicing in Saudi Arabia. We used a self-administered questionnaire consisting of five sections: demographic data, clinical decisions in managing DCL, clinical protocols, and dentist's knowledge about allowing carious dentin to remain under a restoration. The questionnaire was administrated electronically via SurveyMonkey.

Results: A total of 216 pediatric dentists participated in the study, in which nearly 60% were males. Most dentists reported that they preferred partial caries removal (63%), and the Hall technique (68%) was the mostly practiced method in managing DCL. Nearly 93.5% of the dentists reported performing indirect pulp capping before placing a permanent restoration, and the most preferred liner was Dycal (60%). About 47.2% of senior dentists reported practicing complete caries removal. Multivariate logistic regression analysis revealed that younger dentists (5-10 years) preferred practiced partial caries excavation two times more often than senior dentists (>10 years).

Conclusions: Pediatric dentists should focus on minimally invasive approaches such as partial caries excavation for DCL treatment. Pediatric dentists, especially senior practitioners, should be educated and trained to adopt minimally invasive strategies in managing DCL, reducing unnecessary risks such as iatrogenic pulpal damage.