THE ROLE OF CARIES RECOGNITION - TREATMENT DECISIONS FROM BITEWING RADIOGRAPHS

Objective. To describe the effect of the ability to estimate caries de pth from bitewing radiographs on restorative treatment decisions. Meth ods. A 10% random sample of Dutch dental practitioners (n = 444) was s ent a two-part questionnaire based on an analytic approach to radiogra phic caries diagnosis and restorative treatment decision making. In th e second part the dentists were asked to diagnose radiographs of 105 t ooth surfaces with and without dentine caries and then to make a treat ment decision for each surface. A regression analysis was carried out using the negative predictive value (TN/[TN + FN]) of the restorative treatment decision for dentine caries as the dependent variable. Resul ts. The mean negative predictive value for the dentists' proposals fro m radiographs to leave surfaces untreated was 0.77 (SD 0.05; min. 0.60 , max 0.87). Nine significant (P<0.05) variables explained 65% (R(2) = 0.65) of the variation in decision making. One diagnostic ability var iable explained 48% of the variation found. Conclusions. Dentists appe ar to take the seriousness of errors in restorative decisions into acc ount when deciding on treatment. The ability of dental practitioners t o identify and discriminate between lesions in the innner half of the enamel and the outer half of the dentine, however, plays a dominant ro le in their treatment decision making. Copyright (C) 1996 Elsevier Sci ence Ltd for IADMFR.