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Associations between dental treatment in the primary and permanent dentitions using insurance claims data
K E Heller1, S A Eklund, J Pittman
1University of Michigan, School of Public Health, Department of Epidemiology, Program in Dental Public Health, USA. kheller@umich.edu
Purpose:
The purpose of this study was to assess the associations between dental treatment in the early primary dentition and later treatment in the primary and permanent teeth.
Methods:
Delta Dental Plan of Michigan insurance claims data on 9,886 children who were born in 1990 and were covered by dental insurance from 1990-1998 were used. Risk ratios (RR), screening test measures of sensitivity (SN) and specificity (SP), and evidence-based dentistry research measures of Likelihood Ratio (LR) and Number Needed to Treat (NTT) were calculated.
Results:
Primary anterior tooth treatment at ages 0-3 was weakly associated (RR = 1.43, 95% C.I. = 1.23, 1.65) with treatment of the permanent first molars at ages 6-8 and had SN, SP, LR, and NNT values of 7.4, 95.3, 1.57, and 12 respectively. Primary posterior tooth treatment at ages 4-8 was more strongly associated with future permanent first molar treatment with a RR of 2.44 (95% C.I. = 2.26, 2.64) and SN, SP, LR, and NNT values of 65.9, 61.7, 1.72, and 6.
Conclusions:
For this population, early childhood treatment in the primary anterior teeth was a weak predictor of future permanent first molar treatment. Primary posterior teeth treatment, while still not a strong predictor, was better than primary anterior teeth in predicting permanent tooth treatment. Caries treatment at ages 4-8 in the primary teeth was better than treatment at ages 0-3 in predicting permanent first molar treatment.