Changes in management preference of deep carious lesions and exposed pulps: questionnaire studies with a 10-year interval among dentists in Lithuania

We aimed to investigate changes in management preferences for deep carious lesions and pulps exposed during carious tissue removal that occurred during the last 10 years and identify associated dentists’ background factors. The data were collected among dentists registered with the Lithuanian Dental Chamber at two time points using a similar questionnaire. In 2011, 400 randomly selected dentists received a questionnaire by mail, and 153 (38.3%) responded. In 2021, an electronic invitation to an online questionnaire was sent to all members of the Lithuanian Dental Chamber, and 213 (8.9%) dentists responded. The questionnaire included the definitions of management options, a radiograph, and a clinical picture of a deep carious lesion reaching to the inner fourth of dentine in a mature permanent tooth, asked management preferences in four different scenarios, as well as participants’ background characteristics, reasons for management, and procedural preferences. Data were analyzed using bivariate and multivariable analyses. Compared to 2011, participants in 2021 had 60% lower odds of preferring nonselective versus selective caries removal (OR 0.4, 95% CI 0.2–0.7) and endodontic treatment versus nonselective and selective caries removal (OR 0.4, 95% CI 0.2–0.6) in the scenario of asymptomatic and symptomatic (indicating reversible pulpitis at most) deep lesions, respectively. For exposed pulp, participants in 2021 had lower odds than in 2011 of preferring endodontic treatment versus vital pulp therapy (direct pulp capping and pulpotomies) for both scenarios without symptoms (OR 0.4, 95% CI 0.2–0.7) and with symptoms (OR 0.2, 95% CI 0.1–0.4). A higher proportion of respondents in 2021 reported using rubber dam (44% vs. 17% in 2011, p < 0.001) and hydraulic calcium silicate cements as a capping material (68% vs. 40% in 2011, p < 0.001). The management preferences were associated with the university of graduation and the number of years in dental practice, indicating “recommended in textbooks” and “recommended in scientific publications” as reasons for management preferences. To conclude, a change toward less invasive management options was observed. To a certain extent, dentists have implemented evidence-based recommendations in dental practice. To ensure further adoption of scientific evidence, dentists should be encouraged to update themselves on the newest evidence-based practices

Restorative treatment decisions for carious lesions: Do Russian dentists and dental students apply minimal intervention dentistry?

Background - The concept of minimal intervention dentistry (MID) includes both delayed restorative treatment and conservative caries removal, and is now recognised as an evidence-based approach for dental caries management. In order to determine if dental professionals in Russia are incorporating this concept into their clinical practice, we investigated the restorative treatment decisions of Russian dentists and dental students, and the factors associated with these decisions. Methods - We included 171 general dental practitioners and dental therapists (collectively referred to here as “dentists”) from North-West Russia, and 76 dental undergraduate students from the Northern State Medical University in Arkhangelsk (response rate of 11.5% and 67.9%, respectively). Participants completed a questionnaire, which collected background information (sex, region of work, place of dental school graduation, practice type, years of working experience, working in an urban or rural area, and specialisation in restorative dentistry) and information on restorative treatment decisions for proximal and occlusal carious lesions of permanent teeth. Treatment options in accordance with MID were defined as intervention at dentin level and minimally invasive cavity preparation. Multinomial logistic regression was used for statistical analysis. Results - For the proximal carious lesion, 9.4% of participants said they would employ both MID treatment options; 60.7% said they would choose only one; and 29.9% said they would use neither option. For the occlusal carious lesion, the corresponding figures were 37.2%, 52.1%, and 10.7%. No differences in restorative treatment options were observed among general dental practitioners, dental therapists, and dental students. For the proximal carious lesion, dentists from regions outside Arkhangelsk had 4.15 (95% confidence interval [CI] 1.13–15.27) times higher odds of following one versus both MID treatment options. For the occlusal carious lesion, working experience above 15 years was associated with higher odds of using only one versus both MID treatment options (adjusted odds ratio = 3.04, 95% CI 1.33–6.91). Almost all respondents preferred tooth-coloured materials for restorations; more than 75% chose resin-based composite. Conclusions - The majority of Russian dentists and dental students do not apply the MID concept when treating dental caries in permanent teeth. Clinical protocols on dental caries treatment and dental school curriculums should be updated to place an enhanced focus on evidence-based practice and preventive strategies. Further studies with larger samples of Russian dentists and dental students and alternative methods of recruitment are needed to validate our results

Common social determinants for overweight and obesity, and dental caries among adolescents in Northern Norway: a cross-sectional study from the Tromsø Study Fit Futures cohort

Background - Non-communicable general and oral health conditions share common risk factors. Studies investigating common social determinants as risk factors for overweight/obesity and dental caries among the same adolescents are scarce and inconclusive. Methods - This cross-sectional study included data from 464 girls and 494 boys from the population-based Tromsø study Fit Futures, which included first-year students attending upper secondary school in 2010–2011 from two municipalities in Northern Norway (1038 participants in total, 93% participation rate). Multivariable binary logistic regression analyses stratified by sex were used to investigate the association between socioeconomic position indicators (adolescent’s own study program, parents’ education and employment status) and overweight/obesity indicated by body weight and waist circumference, untreated dental caries in dentine, and when these conditions were considered simultaneously. Results - Boys enrolled in the general studies and sports programs (versus vocational) had lower odds of being overweight/obese (POR 0.42, 95% CI 0.20–0.86 and POR 0.24, 95% CI 0.08–0.73, respectively), of having high waist circumference (POR 0.39, 95% CI 0.21–0.75 and POR 0.25, 95% CI 0.10–0.64, respectively), dental caries (POR 0.57, 95% CI 0.32–0.99 and POR 0.47, 95% CI 0.22–0.98, respectively), and being simultaneously overweight/obese, having high waist circumference and dental caries (POR 0.24, 95% CI 0.07–0.81 and POR 0.11, 95% CI 0.01–0.98, respectively). Girls enrolled in the general studies program (versus vocational) had lower odds of having dental caries (POR 0.50, 95% CI 0.30–0.84). Conclusions - Adolescent’s own study program was identified to be a common social determinant for overweight/obesity and dental caries among boys. These results support the broader concept of social determinants as common risk factors for general and oral health conditions, and call for common health promotion strategies addressing these common social determinants among adolescents. However, there is a need for more studies to investigate and better understand the influence of social determinants on health conditions among adolescents

Oral health-related quality of life among students of the Medical University in the Russian Arctic

The aim is to assess oral health-related quality of life (OHRQoL) and factors associated with OHRQoL among the students of the medical university. Methods. The cross-sectional study included 308 Russian speaking third year students aged 19-25 years from the Faculty of General Medicine, Paediatrics, Preventive Medicine and Dentistry of the Northern State Medical University (NSMU), Arkhangelsk, Russian Arctic. The Oral Health (OH) Impact Profile (OHIP-14) was used to measure OHRQoL. Information on socio-demographic factors, self-esteem of tooth and gingiva health, OH behaviour, and diet was obtained from the OH Questionnaire for adults (World Health Organization, 2013). Pearson's chi-square test and multivariable Poisson regression with robust estimate of dispersion were used for statistical analysis. Results: 33,8 % and 18,5 % of students had poor dentition and gingiva, respectively. 39,0 % of students consumed sweet pies/buns more than once a week; 39.0 % of students reported on low OHRQoL. The highest mean scores OHIP-14 were found for the dimensions "physical pain" and "psychological discomfort": 1.59 (95 % confidence interval (CI): 1.43-1.75) and 0.84 (95 % CI: 0.70-0.98), respectively. Female sex (prevalence ratio (PR) = 1.73, 95 % CI: 1.23-2.45), poor self-esteem of teeth health (PR = 2.32, 95 % CI: 1.77-3.04), and sweet pies/buns consumption more than once a week (PR = 1.39, 95 % CI: 1.07-1.80), were all significantly and independently associated with low OHRQoL. Conclusions: Relatively high prevalence of low OHRQoL was observed in the examined students. Female sex, poor self-esteem of teeth health and frequent consumption of sweet pies/buns were associated with low OHRQoL. To enhance OHRQoL in Russian students, the preventive strategies for dental diseases and diet improvement should be implemented

Perceived Stress and Associated Factors in Russian Medical and Dental Students: A Cross-Sectional Study in North-West Russia

The aim was to assess perceived stress (PS) and factors associated with PS in Russian medical and dental students. A total of 406 medical and 283 dental students aged 18–25 years that attended the Northern State Medical University in Arkhangelsk, North-West Russia participated in this cross-sectional study. A structured, self-administered questionnaire was used to collect information on socio-demographic and socioeconomic factors, oral health (OH) behavior, and self-reported OH. All students were clinically examined to assess dental caries, oral hygiene, and gingiva. PS was measured by the Perceived Stress Scale 10 (PSS-10). Of the students, 26.0%, 69.1%, and 4.9% reported low, moderate, and high PS, respectively. Female sex (b = 2.28, 95% confidence interval (CI): 1.38–3.18), dental faculty (b = 1.74, 95% CI: 0.94–2.54), low subjective socioeconomic status (SES) (b = 1.71, 95% CI: 0.91–2.51), and irregular dental visits (b = 1.65, 95% CI: 0.72–2.58) were associated with higher PSS-10 score. These factors were assumed to be clinical meaningful, given that minimal clinically important difference of PSS-10 fell between 2.19 and 2.66 points. The majority of the medical and dental students reported moderate PS. Based on statistical significance and clinical meaningfulness, socio-demographic factors (sex, faculty), subjective SES, and OH behavior (regularity of dental visits) were associated with PS