Caries
Gianna Lugo, DDS (she/her/hers)
Pediatric Dental Resident
Montefiore Medical Center
Montefiore Medical Center
Richmond Hill, New York, United States
Grace Chin, DDS
Attending
Montefiore Health Systems
Bronx, Ny, New York, United States
Alice Lee, DDS
Associate Director/Assistant Professor
Montefiore Medical Center (Bronx, NY)
Bronx, New York, United States
Authors: Grace Chin, DDS and Gianna Lugo, DDS
Purpose: The purpose of this research is to identify practitioner’s treatment decisions on managing primary anterior teeth caries restorative techniques on managing primary anterior teeth caries. The possibility of variation in treatment decisions and restorative techniques by selected characteristics of practitioners will be explored.
Methods: This is a cross sectional study in which data collection occurred over a month period, March 2023. A survey was sent out via email to active American Academy of Pediatric Dentistry (AAPD) members. The population will be pediatric dentists and pediatric dental residents currently in clinical practice.
Results: A total of 505 responses were received, with 285 pediatric dentists fully completing the survey. 61 (13%) respondents are currently in residency, 121 (25%) have graduated residency 1-5 years ago, 60 (13%) have graduated 10-20 years ago, and 160 (33%) graduated over 20 years ago.
65 (14%) stated they work in a hospital setting. 114 (24%) stating they work with government provided insurance, 83 (17%) with fee for service, and 216 (45%) with private insurance.
434 (93%) of respondents agreed white spot lesions are the first signs of tooth decay. 373 (80%) of respondents disagreed that caries into dentin and/or cavitated lesions always require restorative treatment. 422 (97%) of respondents agree that incipient lesions are confined to enamel and can be remineralized.
A descriptive summary of selected characteristics is summarized as frequencies and percentages. Associations between years of practice and usage of SDF as well as association between insurance and usage of Pulpotomy / Pulpectomy were assessed using approximate Person Ch-Squared test via Monte Carlo simulation with N=9999 resampling. In all analyses, statistical significance is claimed at a computed p-value ≤ 0.05 (i.e., result shown in Table 1 is statistically significant). There is a statistically significant association between years of practice and SDF use (p = 0.007). Practitioners in their early years of practice tend to use SDF relatively more frequently. There is not a statistically significant association between insurance and use of Pulpotomy / Pulpectomy (p = 0.5633).
Conclusion: There is not a consistent agreement on guidelines for the selection of materials and techniques in the pediatric dental literature and the choice appears based on the practitioner preference. There are many factors to consider when considering which material and treatment choice to go with such as the location and size of the prepared cavities, physical properties of the restorative material, the gender, age, and socioeconomic status of the patient, esthetics, the type of practice, and the clinician’s experience. There is not a consistent agreement on guidelines for the selection of materials and techniques in the pediatric dental literature and the choice appears based on the practitioner preference. This study helps practitioners identify all the treatment modalities available for anterior primary teeth to dentists and treatment decision influences.