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This study aimed at evaluating dentists' perceived reasons for replacement of restorations and ascertaining the differences arising from dentists' gender, time since graduation and working sector (salaried vs private).A postal questionnaire was sent to a total of 592 working-age general dental practitioners in Finland, 57% (n = 339) responded. The dentists were asked to rank in order of priority the six most common reasons for replacement of composite in the incisors and posterior teeth and amalgam in the posterior tooth from a list of 12 reasons. Ranking order 1 was worth six points and order 6 one point; the non-ranked reasons were equal to zero. Differences in the means of the summed scores of caries-related (RC), fracture- and failure-related (RF) and miscellaneous (RO) groups were evaluated by ANOVA. The level of significance was set at p = 0.05.For each of three restorations, the RF group comprised 48-56% of the sum-scores. Of the single reasons, secondary caries predominated (20-24%). For composite restorations in the incisors, the mean sum-score of the RO group was greater for private-sector dentists (p = 0.04). For composite restorations in the posterior teeth, the mean sum-score of RF group was higher for male than female dentists (p = 0.009). For amalgam, mean score for RF was 10.2, followed by RC (8.5) and RO (1.1).Secondary caries and various fractures and failures predominate as dentists' perceived reasons for replacement of restorations. Private dentists included miscellaneous reasons as one of their six reasons more often than did the salaried dentists. The complex process of treatment planning and decision-making is influenced by many as of yet unknown factors, calling for emphasis on investigating of perceptions.

The purpose of this study was to evaluate factors related to caries in 6-17-year-olds in 2 groups of Norwegian counties between 1966 and 1983. The average number of surfaces filled and permanent teeth extracted due to caries declined in the 4 northern counties from 1967. An increase was recorded in the 7 southwestern counties until 1971, then a decline. In the 1960s significantly more surfaces were filled and teeth extracted in the north compared to the southwest. Based on intra-county comparisons, the decline in surfaces treated was greater in the north between 1967 and 1983; 5.4 +/- 0.4 vs 3.7 +/- 0.7, P0.01. The averages were 1.9 surfaces treated in the north and the southwest in 1983. Higher infant mortality, lower percentage of people with completed senior secondary education, and more inhabitants per doctor and per dentist in the north indicate a less favorable situation than in the southwest. School-based fluoride programs had been implemented in both groups from the mid-1960s and around 60% participated when fluoride toothpaste became freely marketed in 1971. More fluoride programs and more fluoride tablets were available to children in the north; this may indicate a preventive attitude among dentists. The decline of caries started at different times in different parts of Norway. In the rural north with the most unfavorable situation, the decline was greater and started years before fluoride toothpaste came on to the market. The early decline may partly be ascribed to the school-based fluoride programs, the continued decline to several factors.

This study aimed at mapping the preparation techniques and restorative materials that Swedish dentists are using for primary approximal and occlusal carious lesions. It involved sending a pre-coded questionnaire to a random sample of 923 dentists, with eight items concerning approximal and occlusal restorative preparation techniques and dental materials. Responses were received from 651 (70.5%) dentists. To restore a primary approximal carious lesion in an adolescent with low caries activity and good oral hygiene, the tunnel preparation was chosen by 48% of the dentists, the saucer-shaped preparation by 32%, and the traditional Class II preparation by 20%. The most common preparation technique for restoring an occlusal carious lesion was removal of the carious part only, which was chosen by 74% of the dentists. For a lower second molar with a minor occlusal caries lesion combined with a suspected dentin lesion as judged radiographically, about half of the dentists chose to restore the carious part only and 27% would seal the rest of the fissure system in addition. For a similar lesion with no obvious radiolucency in the dentin, about 1/3 chose the 'no treatment' alternative, 1/3 fluoride treatment, and the rest fissure sealing or other techniques. Composite was used most often and amalgam least often for both approximal and occlusal carious lesions.

The ages of 6,761 restorations replaced in permanent teeth, 6,088 in adultsor =19 years of age and 673 in adolescentsor =18 years, were available for analyses. The results showed that the median age of amalgam restorations in adults was 11 years and that of resin-based composite restorations 8 years. This difference in longevity was significant (P = 0.000 l). The median age of failed conventional glass ionomer restorations in adults was 4 years and for resin-modified glass ionomer 2 years. In adolescents, the median longevity of failed amalgam restorations was 5 years and that of composite restorations 3 years, while both types of glass ionomers had a median longevity of 2 years. The data were subdivided based on clinician gender and practice setting. The results showed that the median age of amalgam and composite restorations replaced Its male clinicians was higher than that for female clinicians irrespective of clinical setting. The median age of amalgam and composite restorations replaced by salaried dentists was significantly lower than that by private practitioners. Minor differences were noted in longevity of restorations between male and female patients. The age of replaced restorations was shortest for the group of clinicians with the least clinical experience and highest for those that graduatedor = 30 years ago.

The aim was to study any variability in approximal and occlusal caries diagnoses and restorative treatment decisions among Swedish dentists. The material consisted of a pre-coded questionnaire sent to a random sample of 923 dentists with 4 items concerning approximal and occlusal caries diagnosis and restorative treatment decisions. Responses were received from 651 (70.5%) dentists. In an adolescent with low caries activity and good oral hygiene, more than 90% of the dentists stated that they would not automatically restore a primary approximal caries lesion if its radiographic appearance did not show obvious progression in the outer 1/3 to 1/2 of the dentin. Moreover, 67% of the dentists would only consider immediate restorative treatment of an occlusal surface if obvious cavitation and/or radiographic signs of dentin caries could be observed. When diagnosing questionable occlusal caries, the dentists largely relied on the radiographic appearance. Concerning both approximal and occlusal caries, the threshold for restorative treatment differed between the metropolitan regions in Sweden, and younger more often than older dentists would postpone restorative treatment of approximal caries until the lesion had reached a relatively advanced stage of progression. The responses also showed that dentists in private practice would restore approximal caries at an earlier stage of progression than the dentists in the Public Dental Health Service.

To evaluate Finnish dentists' perceptions of the longevity of direct dental restorations; to assess the possible impacts of dentists' characteristics on these perceptions; and to compare the present longevity estimates with those of recent European reports.A questionnaire to 592 general practitioners, systematically sampled from the Finnish Dental Association's membership list, was posted in April 2004 and data collection was finished by the end of June. The question "In general, what is your estimate for the mean age of restoration in permanent teeth?" pointed restorations: Class II and MOD composites and amalgam in a posterior tooth and Class III composites in an incisor. Dentists' gender, main work, and year of graduation served as background information. Of the 339 (57%) respondents, only public and private dentists were included; 11 were excluded. Three studies fulfilled the inclusion criteria for recent reports on restoration longevity. Statistical evaluation was by one-way ANOVA, with p=0.05 as the level of significance.The mean of the estimates for all types of composite was 9.0 years (SD 3.6; 95% CI 8.6-9.3) and 18.7 years for amalgam (SD 7.3; 95% CI 18.0-19.5). Male dentists gave longer estimates than female dentists for posterior composites, but shorter estimates for amalgam. Compared to public dentists, private dentists gave longer estimates for posterior composites. All estimates were longer than those reported in the recent literature.Dentists' perceptions of posterior composite longevity are significantly longer among males than among females and among private than public sector dentists, and exceed the median longevity reported in recent studies.

The aim of the study was to evaluate the coverage of and time used for caries preventive actions by patient and by dentist's characteristics in relation to caries status and orthodontic treatments in patients from birth to 18 in public dental care in Helsinki City Health Department, Finland. Data on caries prevention for the age groups 0- to 18-year-olds in 1999 were analyzed in relation to patient age, caries status, orthodontic care, and dentist's characteristics. Our study comprised a total of 48,040 patients treated by 140 dentists. Main outcome measures were the coverage of and time used for repeated caries prevention performed during visits following the check-up visit. Nine percent of those under age 6 received repeated caries prevention, 29% of the 6- to 15-vears-olds and 24% of the 16- to 18-year-olds. Nineteen percent in the no-caries group (DMFT/dmft = 0) and 36% in the high-caries group (DMFT/dmft0 and DT + dtor = 3) received repeated caries prevention. The average time a dentist used in repeated caries prevention was 3.6 min (s 3.1: median 2.8; range 0.2-15.4 min) for those in the no-caries and 8.1 (s 6.2; median 7.3; range 0.0-31.8 min) for those in the high-caries group. In each category of caries status, the average time used for repeated caries prevention was shorter for those not under orthodontic treatment. In conclusion, the variation in dentists' caries-preventive treatment practices is wide showing both over- and underuse of caries-preventive actions as judged by needs of patients.

A questionnaire on third-molar problems was mailed to a systematic random sample of 200 Norwegian general dental practitioners in November 1991. The return rate was 88%. Similar questions were given to 59 5th-year dental students, with a return rate of 83%. Ten third-molar cases were presented by means of copies of radiographs and written information. The following conclusions were drawn: Apart from a terminology problem consisting of lack of discrimination between the terms retention and impaction, overall good diagnostic abilities were shown by both practitioners and students. Receiver operating characteristic analysis of treatment decisions indicated that students were more radical than practitioners. The students had an increased referral rate for thiTd-molar surgery, whereas the practitioners indicated a more selective practice of referring advanced cases.