Objective: To identify characteristics associated with early surgical intervention in the caries process. Methods: Dentists in The Dental Practice-Based Research Network (DPBRN; www.DentalPBRN.org) who practiced at least some restorative dentistry were surveyed (n=901). Dentists were asked to indicate whether they would surgically intervene for a series of cases depicting occlusal caries. Cases included a photograph of an occlusal surface displaying typical characteristics of different levels of caries penetration, and a written description of a patient at a specific level of caries risk. Using multivariate analysis, we analyzed associations of surgical intervention with dentist and practice characteristics at different patient caries risk levels. Results: 519 (58%) DPBRN practitioner-investigators responded. For low caries-risk individuals, 63% of dentists would surgically restore lesions penetrating to inner enamel, and 90% would restore lesions located in outer dentin. Dentists in private practice were more likely to intervene surgically on inner enamel lesions, compared to dentists from large group practices (p<.007). For high caries-risk individuals, 77% would surgically restore inner enamel lesions and 94% would restore lesions located in the outer dentin. Again, dentists in large group practices and public health systems were less likely to intervene surgically in enamel lesions, as compared to dentists in private practice (p<.001). Males intervened more frequently on enamel lesions than females (p=.03). Dentists who did not regularly assess caries risk on their patients were more likely to intervene on dentin lesions (p=.005). Regardless of the caries risk scenario, dentists in practices with smaller proportions of self-paying patients were less likely to intervene on dentin lesions (p<.001). Conclusion: Decisions to intervene surgically in the caries process differed by caries lesion depth, patient caries risk, assessment of caries risk, type of dental practice model, and percent of patients who self-pay. Support: U01-DE-16746, U01-DE-16747.