AIM: The present work aims to gain knowledge about dentists' opinions and experiences on assessing the risk factor related to the development of root caries and to help identify any overlooked factors that may contribute to less efficacious clinical outcomes.
METHODOLOGY: A questionnaire related to root surface caries was distributed among practicing dentists in nine different countries, namely the United Kingdom, Libya, Jordan, Saudi Arabia, Egypt, Brazil, India, Malaysia, and Iraq. Questionnaire responses were analyzed, and the results were compared among the groups.
RESULTS: Dentists around the world ranked the oral hygiene status of patients as the most important factor in the development of root surface caries. Patients with poor oral hygiene, active periodontal disease, reduced salivary flow, and gingival recession are perceived to have a higher risk of developing new root surface caries. There is a greater focus on prevention in the UK and greater levels of untreated dental disease in other countries, especially those recovering from civil wars.
CONCLUSION: This work identified some overlooked factors that may have contributed to the less efficacious clinical outcomes reported in the literature. It is hoped that this deep dive into risk factors coupled with the findings presented in Part I of this study will be used as a basis for a more comprehensive investigation into the management of patients with root surface caries.
MATERIALS AND METHODS: The investigation was a cross-sectional study, using a validated questionnaire. The questionnaire sought information on both preclinical and clinical instruction, number and duration of modules, logistics of teaching, clinical requirements and teaching challenges. The data was collected and entered in an MS Excel spreadsheet. The results were collated and analysed.
RESULTS: A survey of all 10 Canadian dental schools revealed a 100% response rate, with all schools confirming they perform composite restoration repairs to extend clinical service. Currently, 70% of schools teach repair techniques in undergraduate clinical training, and 20% plan to introduce such techniques within five years. Furthermore, 100% of schools noted patient willingness to accept repairs. While 70% view repair as a definitive treatment, others see it as temporary (10%) or transitional (20%). Primary reasons for teaching repairs include tooth preservation, pulp protection, marginal defects, and secondary caries. For procedures, 70% teach rubber dam isolation, and 70% use diamond-finishing instruments. Most schools (60%) do not teach bevelling or review repaired restorations, while 60% utilise phosphoric acid etching, adhesive bonding, and nano-filled composites.
CONCLUSION: Undergraduate dental students at most Canadian dental schools are taught repair as an alternative to replacement in the management of defective composite resin restorations. Arrangements to harmonise the teaching of composite repair across Canada and beyond would greatly benefit patients and students nationally and internationally.
CLINICAL SIGNIFICANCE: Teaching composite restoration repair supports minimally invasive dentistry by promoting preservation of sound tooth structure and reducing unnecessary restoration replacement. Greater harmonisation of undergraduate teaching across Canadian dental schools could enhance consistency in clinical practise and improve long-term patient care.