10 May 2023

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Minimally invasive dentistry: how much is it known and applied by dentists?

Lara Figini

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Minimally invasive dentistry (MID) is based on extremely conservative treatments that aim to keep teeth functional for life and free from caries.

The goals of MID are achieved by following important strategies including disease risk assessment and care planning, disease control and prevention, management and minimally invasive surgical repair rather than total replacement of restorations.

Research indicates that dentists who do not regularly provide Caries Risk Assessment (CRA) or dietary advice are more likely to adopt an invasive approach.

A recent systematic review with meta-analysis (Innes, 2017) indicated that a high percentage of dentists still intervene too invasively on carious lesions, therefore less invasive therapies and more conservative treatments should be recommended in clinical practice.

Materials and methods

In a systematic review published online in March 2023 in the Journal of Dentistry, the authors assessed dentists' knowledge, implementation and clinical practice (KAP) of minimally invasive dentistry. Cross-sectional studies analyzing the results of KAP on MID were included in this review.

Eight databases (Cochrane, DOSS, Embase, LILACS, PsycINFO, PubMed, Scopus and Web of Science) and gray literature were queried up to January 2022.

Two independent reviewers selected the included studies, initially based on titles and abstracts and ultimately on full texts. The methodological quality of the studies was assessed using the Joanna Briggs Institute Critical Assessment Checklist for Prevalence Studies.

A proportional meta-analysis was conducted using a random effects model for data analysis. Cochran's Q test and statistical I2 were used to assess heterogeneity.

Results

Of the 2,079 studies initially identified by researchers, 12 were included in the final review.

The meta-analysis was based on data from 10 studies (n = 1,728 participants). The knowledge of the MID was found to be 75.66% (95% CI: 69.33-81.48; p <0.01; I2: 97%; Tau2: 0.0456) and the application of the MID and the practical interventions in MID were found to be 47.95% (95% CI: 38.55-57.43; p < 0.01; I2: 98%; Tau2: 0.0743).

The highest prevalence rates were found in the field of "knowledge" and the lowest in implementation and clinical practice.

Conclusions

From the data of this study, it can be concluded that the knowledge of dentists about minimally invasive MID dentistry is acceptable. However, both its application and the related clinical procedures need improvement. The papers included in this review lack consistency in methods and there is a need for further studies to clarify the KAP of dentists worldwide.

For more information: "Knowledge, attitudes, and practice of dentists on minimal intervention dentistry: a systematic review and meta-analysis."