Development of a Patient-Based Provider Intervention for Early Caries Management

There is great variation in caries diagnosis and management, with many dentists choosing a surgical approach rather than non-invasive treatment methods (“watchful monitoring” combined with prevention) for early caries. Approaches that delay placement of the first restoration may be a key source of improving the long-term effectiveness of dental care. This project focuses on improving the quality of dental care by fostering movement of the latest scientific advances into daily clinical practice in the area of early caries treatment.

The aims of this project are to: (1) develop a patient handout to encourage patient acceptance of non-invasive treatment for early caries in permanent teeth and to increase dentists'' use of non-invasive treatment; (2) quantify patient satisfaction with treatment options for early caries to quantify patient acceptance; and (3) quantify pre- and post-intervention caries stage at which dentists place the first restoration to determine the feasibility of the intervention.

This project entails instrument development as well as a feasibility study that will inform the design of a subsequent clinical trial in dental private practices. Semi-structured qualitative interviews with 30 patients and 10 dentists will be conducted to develop the patient handout. Specific factors from pre-existing patient satisfaction surveys will be used as quantitative tools. The handout will be tested for readability and content structure. The study design is factorial, with patient satisfaction and handout assessment data from 300 surveyed patients diagnosed with early caries by participating dentists. The feasibility study design is longitudinal with pre- and post-intervention caries stage data from each participating DPBRN dentist collected from the practice assessment questionnaires. The 10 practitioners will be recruited to participate in the study, based on their early caries treatment pattern and a stratified convenience sampling scheme that will encourage representation of minority dentists and patients.