Examining Parental Treatment Decisions Within a Contemporary Pediatric Dentistry Private Practice
Authors Kopczynski K, Meyer BD
Received 7 January 2021
Accepted for publication 22 February 2021
Published 25 March 2021 Volume 2021:15 Pages 645—652
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Johnny Chen
Kayla Kopczynski,1 Beau D Meyer2
1Adams School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA; 2Division of Pediatric Dentistry, College of Dentistry, Ohio State University, Columbus, OH, USA
Correspondence: Beau D Meyer
The Ohio State University, College of Dentistry, Division of Pediatric Dentistry, Columbus, OH, USA
Email [email protected]
Purpose: The primary objective of this study was to compare relationships between child, parent, and clinical factors with patient-level treatment decisions for early childhood caries. A secondary objective was to describe children that received silver diamine fluoride (SDF) as interim versus long-term treatment.
Patients and Methods: Parents of 2– 6-year-old children seeking care at a multi-center pediatric dentistry private practice were enrolled in this cross-sectional study. Demographic data and dental anxiety data according to the Modified Corah’s Dental Anxiety Scale were collected via questionnaire. A dental visit behavior rating and decayed, missing, and filled tooth (dmft) index were recorded from the child’s dental record. The primary outcome was treatment decision categorized into three groups: (1) treatment with SDF (n=25), (2) conventional restorative treatment under local anesthesia (n=32), and (3) restorative treatment under general anesthesia (n=33). Analyses included descriptive statistics, bivariate analysis, and ordered logistic regression.
Results: Child age, parent education level, family income, dental insurance status, dental visit behavior rating, and dmft were significantly different across treatment groups in bivariate comparisons. However, when included in multivariable, ordered logistic regression, child dental anxiety was the only significant covariate associated with treatment decisions (Odds Ratio=5.01, 95% confidence interval: 1.51 to 16.63). In secondary analysis, two distinct subgroups were identified within the SDF group: one as long-term treatment (n=9) and one as interim treatment prior to general anesthesia (n=16). The long-term group was younger (mean=3.2 versus 3.7), had lower dmft (mean=4 versus 11.1), and had lower frequency of very high dental anxiety (0% versus 15%).
Conclusion: The present study identified child dental anxiety as the primary factor associated with treatment decisions at this private practice. The characterization of two subgroups of children treated with SDF has meaningful implications for studies evaluating the economic and public health impacts of SDF.
Keywords: dental caries, early childhood caries, preventive dentistry
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