Abstract
Background: Caries lesions had a tremendous impact on the global clinical burden. It can have deleterious effects on the patient’s general wellbeing and oral care. Accordingly, appropriate diagnosis and management of caries lesions can improve clinical outcomes. These clinical outcomes depend mainly on the timing and rationale of the dentist’s decision on the patient’s treatment. This study aims to assess Saudi dentists’ restorative treatment decisions on approximal caries lesions, including treatment threshold and restorative methods and materials.
Methods: This is a cross-sectional survey study that included dentists of different specialists working in Saudi Arabia. We collected demographic and professional information about the dentists, in addition to a case simulation to evaluate their decisions on diagnosis and management of patients. Descriptive and comparative analysis was done using Statistical Package for the Social Sciences version 26.
Results: A total of 104 Saudi dentists participated in this survey, 69.2% male, and 42.3% were aged between 26 and 30 years old. As for professional information, 76.9% of the dentists received education inside Saudi Arabia, and only 2.9% were restorative specialists. Also, 47.1% had between 2 and 5 years of experience, 81.7% worked in the governmental sector, and 69.2% practiced in an urban area. As for diagnosis and management decisions, 61.5% would use fluoride, 61.5% decided that the inner half of dentin would require immediate restorative treatment, 80.8% would use Bitewing X-ray for the detection of interproximal caries, 34.6% decided to use tunnel preparation for the smallest lesion, 55.8% would use Tofflemire band to achieve tight proximal contact, and 60.6% would use composite restorative material for the smallest approximal lesion. Also, dentists aging between 20 and 25 (p-value < 0.001), education inside Saudi Arabia (p-value = 0.002), having a restorative specialty (p-value = 0.04), more years of experience (p-value = 0.018), and working in private sector (p-value = 0.002) significantly preferred the use of fluoride for management of caries lesions.
Conclusion: Saudi dentists showed appropriate decision-making attitude toward restorative treatment for approximal caries lesions. However, decision making is influenced by some professional and demographic factors.

Key words: Dentists, restorative treatment, decision making, approximal caries lesions, Saudi Arabia.