Restorative treatment decisions on occlusal caries in Scandinavia

In order to map variations in the operative treatment threshold for occlusa l caries, a pre-coded questionnaire was sent to a random sample of 759 dent ists in Norway, 923 in Sweden, and 173 in the Danish Public Dental Health S ervice inquiring about car ies and treatment strategies. A further intentio n was to explore the type of operative treatment and filling material denti sts in Scandinavia would use given an occlusal lesion in the lower 2nd mola r in a 20-year-old. It is found that close to 70% of dentists in the 3 coun tries would pur off carrying out operative treatment of occlusal caries unt il riley registered a moderately sized cavity and/or any radiolucency in de ntin. In Sweden, 26.7% of dentists and in Denmark 21.3% would postpone oper ative treatment until the lesion had a large cavity and/or until radiolucen cy could he observed in the middle third of the dentin; in Norway only 11.5 % of dentists indicated this. The majority of dentists in all 3 countries preferred to drill only the carious part of the fissure, though in Norway m ore dentists (30.9%) would tend to drill the whole fissure compared to thei r Swedish (23.4 %) and Danish (9.5%) colleagues. The majority of Danish den tists (52.4%) suggested amalgam for restoring the occlusal surface, while 1 9.9% of Norwegian and 2.9% of Swedish dentists would use amalgam. Composite was the first material of choice for 71.5% of the Swedish dentists, the re maining 25.6% suggesting conventional glass ionomer cement, light-cured 'gl ass ionomer cement', or a combination of glass ionomer cement and composite . The cor responding values for the Norwegian dentists wt re 39.1% and 41.0 %, respectively, and for the Danish dentists 29.2% and 18.4%. In Scandinavi a, the leading strategy for occlusal caries seems to he to postpone operati ve treatment until a definite cavity or radiolucency in the outer third of dentin can be observed, and to carry out operative treatment only of the Pa rt of the fissure that is carious. Composite resin is the predominant mater ial of choice in Sweden, while in Denmark the majority of dentists preferre d amalgam. Composite, or composite in combination with glass ionomer cement material, was the choice of almost 80% of Norwegian dentists.