Dental composite restorations and neuropsychological development in children: Treatment level analysis from a randomized clinical trial

Abstract

Background Resin-based dental restorations may intra-orally release their components and bisphenol A. Gestational bisphenol A exposure has been associated with poorer executive functioning in children. Objectives To examine whether exposure to resin-based composite restorations is associated with neuropsychological development in children. Methods Secondary analysis of treatment level data from the New England Children’s Amalgam Trial, a 2-group randomized safety trial conducted from 1997–2006. Children (N=534) aged 6–10 y with >2 posterior tooth caries were randomized to treatment with amalgam or resin-based composites (bisphenol-A-diglycidyl-dimethacrylate-composite for permanent teeth; urethane dimethacrylate-based polyacid-modified compomer for primary teeth). Neuropsychological function at 4- and 5-year follow-up (N=444) was measured by a battery of tests of executive function, intelligence, memory, visual-spatial skills, verbal fluency, and problem-solving. Multivariable generalized linear regression models were used to examine the association between composite exposure levels and changes in neuropsychological test scores from baseline to follow-up. For comparison, data on children randomized to amalgam treatment were similarly analyzed. Results With greater exposure to either dental composite material, results were generally consistent in the direction of slightly poorer changes in tests of intelligence, achievement or memory, but there were no statistically significant associations. For the four primary measures of executive function, scores were slightly worse with greater total composite exposure, but statistically significant only for the test of Letter Fluency (10-surface-years β= −0.8, SE=0.4, P=0.035), and the subtest of color naming (β= −1.5, SE=0.5, P=0.004) in the Stroop Color-Word Interference Test. Multivariate analysis of variance confirmed that the negative associations between composite level and executive function were not statistically significant (MANOVA P=0.18). Results for greater amalgam exposure were mostly nonsignificant in the opposite direction of slightly improved scores over follow-up. Conclusions Dental composite restorations had statistically insignificant associations of small magnitude with impairments in neuropsychological test change scores over 4- or 5-years of follow-up in this trial.

Low dose effects of bisphenol A

“…3C). [186][187][188][189][190][191][192][193][194] Consistent with a number of rodent studies, several of these studies suggest that low doses of BPA affect behavioral endpoints in children.…”

“…Eight studies examining neurobehavioral outcomes have been published from four prospective US cohorts and a cross-sectional Korean cohort. [186][187][188][189][190][191][192][193][194] These studies focused on pre-and postnatal BPA exposure and neurobehavioral outcomes measured through either parent report or standardized testing. Outcomes included anxious and depressive behavior as well as social and interpersonal problems in children from several age groups.…”

Bisphenol A – Application, sources of exposure and potential risks in infants, children and pregnant women

“…Similarly, in the 3rd trimester of pregnancy, BPA concentration (GM) was 2 μg/g creatinine (0.2-102.6 μg/g creatinine). Bisphenol A concentrations without creatinine correction were at similar levels, 2.1 mg/l (0.1-122.8 mg/l) and 1.8 mg/l (< LOD-103.7 mg/l; LOD = 0.1 mg/l) during the 1st and the 3rd trimesters of pregnancy, respectively [96]. However, prenatal exposure was weakly associated with an increase in waist circumference and body mass index (BMI) in children aged 4 years, compared to the rapid weight gain and growth in the 1st 6 months of life or waist circumference, or an increase in BMI at the age of 14 months.…”

“…This dependence was higher among women who smoked cigarettes during pregnancy [95]. [96], after 5-year follow-up of children aged 6-10 (NECAT) who were exposed to BPA released from dental fillings, also reported no BPA concentration-related change of BMI in children with composite IJOMEH 2015;28(2) 224 been detected in the urine of almost all pregnant women (N = 398) of the cohort (99%). The study suggests a link between the average exposure of mothers to BPA during pregnancy (at 16 weeks) and the increase in respiratory disorders (wheeze) in the progeny at the age of 6 months.…”

“…However, exposure to BPA in women during pregnancy is associated with reduction of TSH in infant boys, and decreased T4 in women during pregnancy [112]. (2012) did not observe statistically significant relationship between BPA released from dental fillings and neurobehavioral effects in children or their physical development [96,121]. Similarly, Yolton et al (2009) showed no association between prenatal exposure to BPA and naurobehavior during early infancy [122].…”