The Diagnosis & Management of Non-Carious Cervical Lesions by Dental Practitioners from the South Yorkshire and Bassetlaw Regions of England

A survey-based study, utilising qualitative and quantitative questions was used to investigate the diagnosis and the management of non-carious cervical lesions (NCCLs), including an overview to the working and gender demographics of primary dental care practitioners in South Yorkshire. To establish the contributing factors associated with NCCLs; to identify the most common approach used by dentists on how to manage NCCLs, and to identify what restorative materials dentists used and why. Objectives: To investigate, by the use of a questionnaire, the diagnosis & management of non-carious cervical lesions by dental practitioners. Materials and Methods: A sample size calculation yielded a survey size of 149, following initial returns (non-responders) the questionnaire was posted to 300 randomly chosen participants. The questionnaire contained an initial demographic section to ascertain; gender, time since graduation and working times (8 questions), and the second section focused 6 questions upon; NCCL diagnosis, management and treatment options. Likert scale (5 point responses: greatly agree to greatly disagree), free- text boxes, closed-ended and multiple-choice questions were used to collect data from respondents. The response rate was (53.3%). Results: Abrasion, particularly tooth brushing, was believed to be the main cause of NCCLs (87%). An initial monitor/ preventative (fluoride application) approach was taken first, with the rationale to restore being based upon patient reported symptoms, first, and then followed by any aesthetic concerns/ preservation of tooth tissue. When NCCLs were being treated there was a wide range of numbers: modal value of 2, and median value of 5 NCCLs being restored per week. Composite was the aesthetic material of choice to restore NCCLs (57%), followed by (30%) for glass polyalkenoate (GI cements) restorations. Conclusion: Our demographic data indicated that the survey cohort could be considered as a representative sample of primary care dental practitioners in terms; of gender, time since qualification (as a proxy of age), and working practice (NHS vs. Private), and sessions worked per week. There was a strong agreement between dentists that tooth brushing abrasion is the main causes of NCCLs., and while the majority of NCCLs are managed conservatively, composite is the most frequent restorative material used by dentists to restore NCCLs followed by GIC. Dentists are more likely to restore NCCLs to improve sensitivity or to preserve remaining tooth structure, than to improve patients' aesthetics. The size of the cavity, the anatomical position of the tooth, the nature of the cause, the aesthetic consideration and the materials' technical properties had an effect on deciding the choice of restorative material.