Application of a Caries Treatment Difficulty Assessment System in Dental Caries Management

Dental caries is one of the most common chronic diseases caused by progressive bacteria, affecting all age groups. Today, restorative fillings are widely used for dental caries treatment, but the restorative treatment has a high failure rate. Meanwhile, many researchers have discovered the differences of caries risk among populations by using the caries risk assessment and put forward a new standpoint that caries should be treated individually. Therefore, our research group established a Dental Caries Treatment Difficulty Assessment system in a previous study. This time, we combined the caries risk assessment with the caries treatment difficulty assessment, then used Python to design a Dental Caries Management Software. The purpose of this case report is to present a case applying this software in dental caries management and other data collected in Chengdu, China, with this software on the assessment of caries treatment difficulty. Patients with personalized assessment and management can achieve good treatment results, including reducing the risk and treatment difficulty of dental caries. At the same time, other cases show that the software has good application potential in individual management and group information collection. These cases indicate that the software enables dentists to carry out both the risk assessments and the treatment difficulty assessment of patients, and it has the potential as a tool for epidemiological investigation. It also enables dentists and patients to have a basic understanding of the dental health status of patients and create personalized dental caries treatment, so as to achieve the goal of controlling the progression of dental caries and rebuilding the structure and restoring the function of teeth.

Dental caries management: A practical approach for your practice

Chronic disease management models in primary care have demonstrated significant benefits to the patient experience and patient health outcomes. In trying to prepare for the future, with or without COVID-19 implications, dental providers and clinics are facing opportunities to add value, consider alternative payment models, and to incorporate risk stratification and population health management along with medical systems. However, as alternative payment models emerge in dentistry, stand-alone dental clinics may face unique challenges in trying to prepare for the future while still providing patient care in the fee for service environment. This article focuses on a 6-months pilot project of how implementing a comprehensive caries disease management care model, evaluating caries risk, and implementing risk stratification strategies can prepare dental offices for future payment models and inclusion in the greater health system. There are two overall goals for this pilot. First, applying a caries disease management protocol to every patient visit, regardless of reimbursement. Second, applying quality improvement (QI) principles to change how a dental office approaches care delivery. The Institute of Medicine defines quality in healthcare as a direct correlation between the level of improved health services and the desired health outcomes of individuals and populations.

Management of initial carious lesions: Iowa survey

BACKGROUND

The authors explore Iowa dentists' agreement with the International Caries Classification and Management System (ICCMS) in the nonsurgical management of initial carious lesions in patients at low, moderate, and high caries risk and identify factors related to their agreement.

METHODS

Electronic surveys were mailed to 916 actively practicing dentists who are alumni of the College of Dentistry at The University of Iowa. Questions included clinical scenarios that used text, clinical photographs, and radiographic images of initial carious lesions. Dentists were asked what type of treatment they would recommend. Treatment options included no treatment, nonsurgical treatment, or surgical treatment. Logistic regression analyses were used to assess associations among agreement with ICCMS, characteristics of the dentist's practice, and patients' caries risk level.

RESULTS

A total of 138 Iowa dentists responded to the survey. Agreement with ICCMS regarding nonsurgical management of initial carious lesions for patients at low, moderate, and high risk levels were 73%, 59%, and 51% respectively. Compared with their counterparts, dentists who agreed with the recommendations for nonsurgical treatment were more likely to dry the teeth during caries detection (95% confidence interval [CI], 1.02 to 12.67, P = .0468), use magnification (95% CI, 1.16 to 7.17, P = .0225) for caries detection, have graduated less than 20 years ago (P = .0024), practice in public health settings (P = .0089), and perform a caries risk assessment (95% CI, 1.10 to 4.29, P = .0262).

CONCLUSIONS

Dentists who dry teeth, use magnification for caries detection, graduated in the past 20 years, practice in a public health setting, and perform a caries risk assessment were significantly more likely to make decisions that were consistent with the guidelines of the ICCMS.

PRACTICAL IMPLICATIONS

Knowledge of evidence-based options personalized for a patient's risk status is essential for applying the best management of initial caries lesions.