Assessing the Acceptability of Less Invasive Caries Removal Techniques for treating Deep Carious Lesions: A Conjoint Survey among Dentists Practicing in a Midwestern American State

Abstract

This study identified factors that influence dentists’ decisions regarding less invasive caries removal techniques such as stepwise removal (SW) and selective removal (SE) using a marketing research technique, conjoint analysis. A survey was sent to 1,434 dentists practicing in Iowa. Dentists were randomly assigned to receive a questionnaire to rate the likelihood they would use either SW/SE in hypothetical clinical scenarios. The scenarios were carefully created by conjoint design and included three relevant attributes: <i>depth of lesion, hardness of carious dentin</i>, and <i>patient age</i>. Descriptive and conjoint analyses were performed to assess trade-offs between these attributes, using SPSS. The study revealed that <i>depth of lesion</i> was the most important factor in the dentists’ decisions (49 importance value) when choosing a SW to treat a deep carious lesion, followed by <i>hardness</i> of carious dentin and <i>patient age</i> (21 importance value). For the SE group, <i>depth of the lesion</i> was also the predominant factor when selecting a treatment. The study also identified that a high proportion of dentists (24.9%) indicated they would never consider using SW or SE under any circumstances. Our survey showed that <i>depth of lesion</i> was the most important reason to select a less invasive caries removal method. The high proportion of dentists indicating they would never consider selective caries removal (SE) techniques suggests that these less invasive options are underutilized.