Utilization of Stainless Steel Crowns by Pediatric and General Dentists

Dental caries affects 23 percent of U.S. children aged two to five years old. 1 Stainless steel crowns (SSCs) are used for extensive caries and offer greater longevity than other restorations; however, disparity exists between pediatric and general dentists in restoration type provided. The purpose of this study was to evaluate utilization of stainless steel crowns among pediatric and general dentists by reviewing insurance claims. Data were obtained from a commercial dental insurance claims data warehouse from more than 50 dental insurance plans and multiple carriers in the United States for children 12 years old and younger. Data were examined for treatment of the primary dentition using SSCs or direct restorations. A generalized linear mixed effects model tested differences in the utilization of SSCs by general dentists (GDs) versus pediatric dentists (PD). The data included 107,487 GDs and 5,395 PDs. The records included 2,555,726 claims for direct restorations and 440,423 claims for SSCs. PDs are more likely to place SSCs compared to GDs (odds ratio equals 3.2; P<0.0001). Pediatric dentists are more likely to restore carious primary dentitions with stainless steel crowns than general dentists. Perhaps increased training at the dental undergraduate level and access to more continuing education courses for general dentists would increase the utilization of SSCs.