Survival of Teeth Restored with Atraumatic Restorative Treatment in a Pediatric Rural Population

Abstract

Objectives: To determine the overall 5-year survival rate of teeth treated by atraumatic restorative treatment (ART) delivered by general practitioners in a rural population in Washington State, USA.Methods: Inclusion/exclusion criteria included children (≤ 12 years and younger) who received ART on asymptomatic carious primary teeth without history of previous restoration (N=178). For this longitudinal study, data collection included demographics, health status, initial date of ART placement, date of ART re-placement, and baseline dmft/DMFT. Variables collected at follow ups included appointment dates, dmft/DMFT, final restorative treatment, pulp therapy, and extraction. Descriptive statistics were calculated for all variables while Kaplan-Meier survival curves were used to summarize overall treatment success. Unadjusted and adjusted hazard ratios (HR) from Cox Proportional Hazard Regression with robust standard error were used to compare survival rates for variables of interest (P<0.05). Results:The overall 5-year survival rate of primary teeth receiving ART restorations was 69.5%. While age, gender, baseline dmft/DMFT, tooth type, and number of ART surfaces were not associated with tooth survival time, child's health status had a significant association (p=0.02). Conclusion:Among this pediatric rural population, a significant tooth survival rate was observed following treatment with ART. Replenishing ART was successful in extending survival tooth until their natural exfoliation or placement of a definitive restoration.