Association between caries location and restorative material treatment provided

Objectives: This cross-sectional study by NW PRECEDENT practitioners correlated the location of caries diagnosed in the past 12 months with treatment provided.

Methods: An oral health survey was conducted on approximately 18 patients in each of 73 practices in the NW PRECEDENT network. Eligible patients (total of 1338 aged 3-92) were randomly assessed for the location of and treatment provided for caries lesions diagnosed within the past 12 months. Regression analysis (GEE) was performed to assess association of treatment to tooth location and surface characterization, adjusting for age, practice location (urban/rural), dentist gender and experience level. The analysis accounts for clustering by practice using robust variance estimates.

Results: Overall, 54.8% of patients exhibited recent caries, 42.8% received treatment for at least one tooth. 17% of treated teeth were treated with amalgam, and 73% treated with composite. This percentage varied as a function of tooth surface characteristics, patient characteristics, and dentist characteristics. Molars were more likely than bicuspids (10%, p<.001) or anterior teeth (27%, p<.001) to be treated with amalgam. Molars were less likely than bicuspids (15%, p<.001) or anterior teeth (40%, p<.001) to be treated with composite. Mesial and distal surfaces were more likely to be treated with amalgam (10%, p<.001) and less likely to be treated with composite (12%, p<.001). An interesting effect born out by the analysis is that female dentists were 54% less likely to use composite (p<0.001) and 35% more likely to use amalgam (p=0.001), than their male counterparts. There were no significant differences by patient age or location of the practice (suburban, urban, or rural) after adjusting for the other factors.

Conclusion: Restorative material choice varied based on caries location and practitioner gender. Submitted on behalf of Northwest PRECEDENT, NIDCR grants DE016750/DE016752.