Deep caries removal strategies: Findings from The National Dental Practice-Based Research Network

, M Marianne Jurasic, Suzanne Gillespie, Pina Sorbara, Janet Clarkson, Craig Ramsay, Denis Nyongesa, Deborah McEdward, Gregg H Gilbert, William M Vollmer

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Background: The International Caries Consensus Collaboration (ICCC) has published recommendations on carious tissue removal to treat cavitated carious lesions in a manner that preserves hard tissue and retains teeth long term. This study quantifies The National Dental Practice-Based Research Network dentists' use of selective caries removal.

Methods: This cross-sectional questionnaire study assessed reported use of selective caries removal when treating deep caries in asymptomatic and symptomatic teeth in response to clinical case scenarios. Statistical methods included the proportion of respondents concordant with ICCC guidelines at various thresholds and logistic regression to model factors associated with concordance.

Results: A total of 500 dentists responded. The study sample was 57% male, mean (SD) age was 50.9 (12.6) years, and 60% worked in private practice settings. Higher levels of concordance for choosing selective caries removal 50% or greater of the time were found for asymptomatic (62.4%; 95% CI, 57.6 to 67.2) than for symptomatic caries (49.3%; 95% CI, 44.4 to 54.2). These differences were significantly associated with type of practice setting.

Conclusions: The National Dental Practice-Based Research Network dentists reported using selective caries removal strategies when managing deep carious lesions more often than in previous US and Japanese practice-based research network studies and from results of a systematic review and meta-analysis. Nonetheless, substantive discordance with the ICCC guidelines was seen by the authors of this study.

Practical Implications: More dissemination and continuing education activities, as well as implementation studies, may further encourage use of selective caries removal to soft or firm dentin when indicated.

Original languageEnglish
Pages (from-to)1078-1088
Number of pages11
JournalJournal of the American Dental Association
Issue number11
Early online date26 Sept 2022
Publication statusPublished - Nov 2022


  • Male
  • Humans
  • Middle Aged
  • Female
  • Dental Caries Susceptibility
  • Cross-Sectional Studies
  • Dental Care
  • Dental Caries/surgery
  • Tooth
  • Practice Patterns, Dentists'


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