The fate of 5,168 carious primary molar teeth from a

cohort study of 2,654 children aged ~5 years at

baseline undertaken by Cardiff University School of

Dentistry in 1999-2003 was investigated

Chadwick, B.L.

Playle, R.A.

Stephenson, John

Treasure, E.T.

English

University of Huddersfield Repository

University of Huddersfield RepositoryStephenson, John, Chadwick, B.L., Playle, R.A. and Treasure, E.T.Assessment of efficacy of treatment of carious primary molar teethOriginal CitationStephenson, John, Chadwick, B.L., Playle, R.A. and Treasure, E.T. (2009) Assessment of efficacy of treatment of carious primary molar teeth. In: British Society for Dental Research Annual Conference 2009, 1st-4th September 2009, Glasgow, Scotland. (Unpublished)This version is available at http://eprints.hud.ac.uk/7909/The University Repository is a digital collection of the research output of theUniversity, available on Open Access. Copyright and Moral Rights for the itemson this site are retained by the individual author and/or other copyright owners.Users may access full items free of charge; copies of full text items generallycan be reproduced, displayed or performed and given to third parties in anyformat or medium for personal research or study, educational or not-for-profitpurposes without prior permission or charge, provided:• The authors, title and full bibliographic details is credited in any copy;• A hyperlink and/or URL is included for the original metadata page; and• The content is not changed in any way.For more information, including our policy and submission procedure, pleasecontact the Repository Team at: E.mailbox@hud.ac.uk.http://eprints.hud.ac.uk/J Stephenson, BL Chadwick, RA Playle, ET TreasureApplied Clinical Research & Public Health, School of Dentistry, Cardiff University, Cardiff, GBASSESSMENT OF EFFICACY OF TREATMENT OF CARIOUS PRIMARY MOLAR TEETHINTRODUCTIONThe fate of 5,168 carious primary molar teeth from acohort study of 2,654 children aged ~5 years atbaseline undertaken by Cardiff University School ofDentistry in 1999-2003 was investigated.RESULTSMarginal survival modelsMarginal survival models -experience in the absence of otherextraction and exfoliation, withAIMS & OBJECTIVES• To model the survival experience of carious primarymolar teeth and surfaces using competing risksparametric survival analysis methods, within theframework of a hierarchical frailty model• To assess the effect of restorative treatment on survivalexperience, in terms of likelihood of subsequentextraction, exfoliation or further treatment• To identify any links between age at caries occurrence,tooth parameters and demographic factors withsubsequent requirement for further treatmentMATERIALS & METHODSdata nested within children. Calculationstatistics showed the log-logisticadequate fit to the data. Tooth-levelRestorative treatment had the greatestoutcome. Fluoride had a moresurvival to extraction, with othersubstantive effect. Exfoliation ratestreatment, or by demographic orCumulative incidence survivalChildren were selected from fluoridated areas in the WestMidlands and non-fluoridated areas in South Wales.Caries data was recorded on all surfaces of all primarymolar teeth on 3 occasions at intervals of ~2 years. Thegender, age at each exam and socio-economic status ofall children was recorded. Tooth and surface parameterswere also recorded. DPB treatment data from consentingchildren (~51%) was incorporated into the data set.Parallel analyses were undertaken on surface data andon the data transformed into tooth-level responses.Parametric survival modelling considering the competingrisks of extraction, further treatment and exfoliation undervarious modelling distributions was undertaken.Cumulative incidence survival functionsactual survival experience for thisAbout 85% of filled carious teethcarious teeth subsequently exfoliateEarly caries occurrence islikelihood of subsequent extraction-CF14 4XYdeintyddiaethdentistrySCHOOLofdentistryysgolamdeintyddiaeThinterpreted as survivalrisks - were derived forsurface- and tooth-levelRESULTS (continued)Calculation of odds ratios showed treatment to besignificantly associated with subsequent extraction (oddsratio 0.13: 95% confidence interval (0.12, 0.14). Time ofcaries occurrence was also significant.of likelihood ratiodistribution to be anresults are illustrated.effect on expectedlimited effect on marginalcovariates showing littlewere not affected bytooth factors.functionsAssessing treatment efficacy: (i) multiple transitionsCaries may re-occur in filled teeth, which maysubsequently require further treatment.The likelihood of eachoutcome, conditional oncaries re-occurrence, isexpressed in terms of age atwhich the tooth is recordedas filled (no decay).Further decay is negligible inteeth recorded as filled with no decay beyond ~10 years.(ii) Mean residual decay lifetime (MRDL)MRDL is the expected time that a carious tooth remains ina decayed state before loss from the mouth. Restorativetreatment reduces MRDL,which may be beneficial to67Reduction in mean residual lifetime resultuing from filling teeth (years)for extraction givefailure mode.and 45% of unfilledby age 14 years.associated with higher.CONCLUSIONSFilling carious primary molar teeth significantlyincreases the likelihood of subsequent exfoliation,with the greatest benefits arising from earliertreatment. Fluoride also has a beneficial effect ontooth survival.successional permanentteeth. A tooth filled at 8 yearssaves ~2 years MRDL. Atooth filled at 11 years saves~1 year MRDL.0123452 4 6 8 10 12 14Reduction in mean residual lifetime resultuing from filling teeth (years)Age  when observed carious (years)Non-fluoridated areaFluoridated area

Assessment of efficacy of treatment of carious primary molar teeth

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