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Changes in the Treatment Concept for Approximal Caries from 1983 to 2009 in Norway

The aim was to measure variations in threshold for operative treatment of approximal caries in permanent teeth and the use of restorative materials, compared with results from studies conducted in Norway in 1983 and 1995. In 2009, a precoded questionnaire was sent electronically to 3,654 dentists with E-mail addresses in the member register of the Norwegian Dental Association. The questions were related to caries, treatment strategies and choice of dental materials. Replies were obtained from 61% of the dentists after two reminders. Restorative treatment of approximal lesions confined to enamel, based on radiographic appearance, was proposed by 7% of the dentists, compared with 66% in 1983 and 18% in 1995. Younger dentists, significantly more often than older, would defer operative treatment of approximal lesions until the lesion was visible in dentine. While tunnel preparation most often was the preparation of choice in 1995 (47%), saucer-shaped preparation was most favoured in 2009 (69%). Tunnel preparation was only preferred by 4% of the dentists. Resin composite was the restorative material preferred by 95%, compared with 16% in 1995. The corresponding values for conventional glass ionomer cement (GIC) were 1 versus 22%, for resin-modified GIC 1 versus 7%, and for a combination of GIC and resin composite 2 versus 22%. Compomer was preferred by 1% of the respondents. The authors conclude that treatment concepts for approximal caries have changed considerably during the last 26 years. In 2009, only 7% of dentists reported that they would treat approximal caries operatively before the lesion reached dentine.