Fellows, Jeffrey L2; Gordan, Valeria V2; Gilbert, Gregg H2; Rindal, D Brad2; Qvist, Vibeke3; Litaker, Mark S2; Benjamin, Paul2; Flink, Håkan2; Pihlstrom, Daniel J2; Johnson, Neil2
1 Section 02 - Paediatric Dentistry, Department of Odontology, Faculty of Health and Medical Sciences, Københavns Universitet2 unknown3 Section 02 - Paediatric Dentistry, Department of Odontology, Faculty of Health and Medical Sciences, Københavns Universitet
multiple-regression modeling of observational clinical data from the National Dental PBRN
PURPOSE: Current evidence in dentistry recommends non-surgical treatment to manage enamel caries lesions. However, surveyed practitioners report they would restore enamel lesions that are confined to the enamel. Actual clinical data were used to evaluate patient, dentist, and practice characteristics associated with restoration of enamel caries, while accounting for other factors. METHODS: Data from a National Dental Practice-Based Research Network observational study of consecutive restorations placed in previously unrestored permanent tooth surfaces and practice/demographic data from 229 participating network dentists were combined. ANOVA and logistic regression, using generalized estimating equations (GEE) and variable selection within blocks, were used to test the hypothesis that patient, dentist, and practice characteristics were associated with variations in enamel restorations of occlusal and proximal caries compared to dentin lesions, accounting for dentist and patient clustering. RESULTS: Network dentists from five regions placed 6,891 restorations involving occlusal and/or proximal caries lesions. Enamel restorations accounted for 16% of enrolled occlusal caries lesions and 6% of enrolled proximal caries lesions. Enamel occlusal restorations varied significantly (P < 0.05) by patient age and race/ethnicity, dentists' use of caries risk assessment, network region, and practice type. Enamel proximal restorations varied significantly (P < 0.05) by dentist race/ethnicity, network region, and practice type.
American Journal of Dentistry, 2014, Vol 27, Issue 2, p. 91-9
Adolescent; Adult; Age Factors; Aged; Community-Based Participatory Research; Dental Caries; Dental Caries Susceptibility; Dental Enamel; Dental Restoration, Permanent; Dentin; Dentist's Practice Patterns; Ethnic Groups; Female; Humans; Linear Models; Male; Middle Aged; Professional Practice; Regression Analysis; Risk Assessment; Tooth Crown; United States; Young Adult