Supplementary Material for: Diagnostic Approaches and Treatment Strategies for Deep Carious Lesions Among Dentists in Egypt and Saudi Arabia: A Questionnaire-based Cross-sectional Study

Aim: To assess and compare the use of diagnostic methods, clinical decision-making, treatment strategies, and attitudes of general dentists, pediatric dentists, and endodontists regarding deep carious lesions (DCL) in Egypt and Saudi Arabia.
Methods: A cross-sectional multinational study was conducted in Egypt and Saudi Arabia (January 2023–June 2024). A validated online questionnaire was distributed to 1,000 dentists (734 Egypt; 266 Saudi Arabia), including general practitioners, pediatric dentists, and endodontists. The survey covered demographics, diagnostics, clinical scenarios, treatment strategies, and influencing factors. Data were analyzed using SPSS v26 with descriptive statistics, chi-square tests, and logistic regression (p < 0.05).
Results: A total of 500 dentists responded (response rate of 46.0% for Egypt (338/734) and 60.9% for Saudi Arabia (162/266)). Most participants were general practitioners (60.4%) and female (57.8%), with an average of 9 years of clinical experience. Selective caries removal was preferred by 23.2% of general practitioners, 34.2% of pediatric dentists, and 21.8% of endodontists. Multivariable regression analysis showed that selective caries removal was more likely to be chosen by pediatric dentists (AOR = 1.38, p = 0.04), dentists practicing in Egypt (AOR = 2.70, p < 0.001), and those who had attended MID courses (AOR = 1.75, p < 0.001). Endodontists demonstrated greater adherence to evidence-based guidelines (AOR = 3.35, p < 0.001), whereas practicing in Egypt (AOR = 0.43, p = 0.002), having more years of experience (AOR = 0.94, p = 0.001), and attending MID courses (AOR = 0.57, p = 0.03) were associated with lower odds of adherence.
Conclusions: Pediatric dentists, practitioners in Egypt, and those with MID education were more likely to favor selective caries removal, whereas endodontists demonstrated the highest AAE guideline adherence and preferred more invasive treatment strategies.
Clinical Significance: Despite current evidence supporting conservative caries removal strategies when managing DCL on vital teeth, invasive treatment strategies in management of DCL was reported in this study amongst respondents. Optimal, patient-centered treatment strategies should be implemented to a greater degree by dentists in Egypt and Saudi Arabia.