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Preventive
Purpose: The purpose of this study was to understand sessional clinical instructors’ knowledge of the principles of minimal intervention dentistry in the management of carious lesions.
Methods: A qualitative exploratory approach of inquiry was utilized, and purposeful selection identified sessional instructors for semi-structured interviews. The interview guide presented three clinical scenarios exploring knowledge of five domains: knowledge base, risk assessment, diagnosis, synthesis, and choice of surgical/non-surgical therapy. Thematic analysis of interviews was conducted with an interpretive inductive approach.
Results: Nine interviews were completed. Participants consisted of 6 males and 3 females between 55-76 years of age, with 32-45 years of private practice experience, and who had taught between 3-19 years. One theme that emerged was “foundational knowledge” and the following categories emerged: caries detection methods, caries detection limitations, evaluating lesion activity, categorizing caries risk, and selective versus complete dentin removal. The second theme that emerged was “clinical decision making for non-cavitated and cavitated lesions” and the following categories were identified as influencing the decision to manage a lesion conservatively: adherence to oral health measures, diagnostic uncertainty and assessment of cavitation, pulpal diagnosis, patient cooperation, and economics.
Conclusions: Participants demonstrated consistent levels of foundational knowledge related to caries detection strategies and determining lesion activity. Variation among individuals presented related to synthesis of patient risk factors and subsequent categorization of a patient’s caries risk level. Diagnostic certainty influenced whether the participant opted to manage a carious lesion conservatively. Continued education provided to sessional instructors could promote current and consistent caries management techniques.