Dentin caries sealing in primary teeth and the perspective of Brazilian dentists: A questionnaire validation and cross-sectional study.

OBJECTIVES

Little is known about dentists' practices regarding the sealing of dentin lesions. The aim of this study was to evaluate Brazilian dentists' knowledge, attitude, and clinical practice regarding the sealing of dentin caries lesions in primary molars.

METHODS

A cross-sectional online survey was conducted with a random sample of 402 dentists. The questionnaire was validated, and the final version included demographic questions, clinical cases with ICDAS 4, 5, and 6 to assess attitude and practice concerning caries sealing, and questions regarding knowledge of caries sealing. Data were analyzed by multiple logistic regression model.

RESULTS

Among respondents, 64.1 % had an academic degree in pediatric dentistry. Caries sealing was the most recommended procedure (69.1 %) for ICDAS 4 (outer dentin). For ICDAS 4 (inner dentin), 5, and 6, partial caries removal was preferred. Dentists with academic-based knowledge and pediatric dentistry degrees were 2.85 and 1.98 times more likely to recommend sealing for ICDAS 4 (outer dentin), and 1.82 times for ICDAS 4 (inner dentin). Academic knowledge increased the likelihood of indicating dentin caries sealing 3.61-fold for ICDAS 5, while a pediatric dentistry degree raised it 1.54-fold for ICDAS 6. The main reasons for caries sealing were scientific basis and minimally invasive dentistry (MID) principles.

CONCLUSIONS

Brazilian dentists demonstrated average to good knowledge of sealing dentin caries lesions and adopted MID for managing caries lesions in primary molars. Academic-based knowledge and pediatric dentistry degrees were associated with a higher likelihood of recommending sealing of dentin caries lesions.

CLINICAL RELEVANCE: Holding a degree in pediatric dentistry and academic-based knowledge influenced the recommendation to seal carious lesions in primary molars. However, the variations in clinical decisions highlight the need of guidelines to ensure consistent diagnosis and intervention of carious dentin tissue, and quality of care.