Restorative Certainty and Varying Perceptions of Dental Caries Depth Among Dentists

Objective: The question of whether dentists who most frequently identify tooth surfaces for definite restoration perceive dental caries as significantly deeper than other dentists is assessed. Methods: One group of 20 dentists independently examined 145 unrestored approximal tooth surfaces on 16 bitewing radiographs and recorded their restorative and depth decisions. Another group of 15 dentists similarly scored 304 unrestored surfaces on 30 bitewing radiographs. Each group of dentists was later divided into four subgroups according to the number of surfaces designated for definite restoration by each dentist. Results: As the number of tooth surfaces designated for definite restoration increased, mean caries depth (P<.05 for the high vs low subgroups) and the percent of dentinally carious surfaces increased, while the percent of surfaces assessed as sound decreased. Dentists with the lower numbers of surfaces designated for definite restoration came closest to the true histologic mean caries depth of the examined tooth surfaces. Conclusions: Dentists who designated high numbers of approximal tooth surfaces for definite restoration assessed caries as deeper than other dentists, and deeper than was proven histologically.