Diagnosis of caries and treatment decisions in approximal surfaces of posterior teeth in vitro.

The diagnosis of caries and treatment planning decisions have been reported to vary widely between individual dentists. However, opinions differ as to whether, in general, this results in too much or too little treatment. Eighty-six dentists, mainly attending post-graduate meetings, participated in this study. They were asked to make diagnostic and treatment planning decisions on a selection of extracted teeth set in realistic contact with each other. These decisions were compared with the appearance of the proximal surfaces before setting the teeth in contact, and the histological appearance of the teeth that were sectioned after the dentists had made their decisions. Opinions as to whether caries was present and whether it required treatment showed a wide distribution. However, had the decisions been acted upon, between 1-6% of the sound surfaces would have been filled, but 20-68% of teeth with clearly cavitated surfaces or histological evidence of dentine involvement would not have been filled.