AAPD 2015: Full-coverage restorations results in fewer caries relapses

SEATTLE - The current U.S. standard of care for treating early childhood caries results in inadequate clinical outcomes, according to a poster presentation on May 22 at this week's American Academy of Pediatric Dentistry (AAPD) 2015 annual meeting.

In a study from New York City, researchers reviewed records over a five-year period and found that even after aggressive surgical treatment under general anesthesia, more than 63% of pediatric patients with early childhood caries who were treated had a relapse of caries in the first three years after the procedure.

The researchers from the Columbia University College of Dental Medicine reviewed the records of more than 600 children treated at Morgan Stanley Children's Hospital of NewYork-Presbyterian through the dental school's Pediatric Dentistry Service. They classified these patients according to gender, age, and type of restorative treatment. After review and exclusion, they included 96 patients in the study who had been treated under general anesthesia.

The researchers found that the relative risk of caries relapse for teeth treated with nonfull coverage restorations was 10 times that of teeth treated with full-coverage restorations. Compliance with recall visits was generally low, the study authors noted.

They cautioned, however, that study limitations included a largely homogenous population (most Hispanic in this case) and only drawn from a single geographic area. They also noted the difficulties of a retrospective study, including restoration choice and provider subjectivity.

The study authors recommended that alternative clinical models be explored, such as disease management, therapeutic treatment, integration of social workers into treatment team, and use of new technologies.

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