Key Points
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The study examined the usage of amalgam for restoring posterior teeth in an Asian country using the nationwide health insurance database.
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Amalgam was still chosen as the filling material in half of the direct restorations of posterior teeth.
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Amalgam was more likely to be used for primary molars, in younger patients, by older dentists, and in dental clinics compared to hospital settings.
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Since teeth from the same individual are correlated in some ways, it is important to use statistical analysis taking into account the intra-individual correlation.
Abstract
Objective: This study investigated the prevalence of and factors associated with amalgam restorations of posterior teeth in Taiwan.
Method: The authors analyzed the dental data regarding direct restorations of posterior teeth from the National Health Insurance Research Database of 1997, which was the first nationwide data available. The chi-square test and analysis of variance was used to compare the characteristics of the teeth, patients, dentists, and dental treatment settings between amalgam and composite restorations. The multivariate analysis was applied to obtain the Generalized Estimating Equation estimation for associations of multiple factors with amalgam restorations, taking into account the intra-individual correlation of teeth restored.
Results: Amalgam was used in 53.3% of the direct restorations of posterior teeth. When all the important factors were assessed simultaneously, characteristics significantly associated with more amalgam restorations were: dentists aged 43 years and above, patients aged 1–22 years, primary molars, two- or three-surface cavity, regions with higher number of population served per dentist, and dental clinic.
Conclusion: Doctors' age, patients' age, type of dental treatment settings, population served per dentist, type of tooth, and number of surfaces restored were significantly associated with amalgam restorations in Taiwan.
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References
Council on Scientific Affairs, American Dental Association Dental amalgam: Update on safety concerns. JADA 1998; 129: 494–503.
Christensen GJ Amalgam vs. composite resin: 1998. JADA 1998; 129: 1757–1759.
Wilson NH, Burke FJ and Mjör IA Reasons for placement and replacement of restorations of direct restorative materials by a selected group of practitioners in the United Kingdom. Quintessence Int 1997; 28: 245–48.
Mjör IA, Moorhead JE Selection of restorative materials, reasons for replacement, and longevity of restorations in Florida. J Am College Dent 1998; 65: 27–33.
Mjör IA Selection of restorative materials in general dental practice in Sweden. Acta Odontol Scan 1997; 55: 53–57.
Widstrom E, Forss H Dental practitioners' experiences on the usefulness of restorative materials in Finland 1992-1996. Br Dent J 1998; 185: 540–542.
Mjör IA, Moorhead JE, Dahl JE Selection of restorative materials in permanent teeth in general dental practice. Acta Odontol Scand 1999; 57: 257–262.
Department of Health, Executive Yuan, the Republic of China. Public Health of the Republic of China pp 96–118 Taipei 1998.
The GENMOD procedure. In: SAS/STAT software: changes and enhancements through release 6.12. pp 247–348 Cary, NC: SAS Institute Inc 1997.
Hosmer DW, Lemeshow S Applied logistic regression. New York: John Wiley & Sons pp 82–134 1989.
Department of Health, Executive Yuan, the Republic of China. The 1997 health and vital statistics. pp 132 Taipei 1998.
World Health Organization. WHO estimates of health personnel: Physicians, nurses, midwives, dentist and pharmacists (around 1998). Available at: Accessed December 7, 2000 http://www-nt.who.int/whosis/statistics/health_personnel/health_personnel.cfm?path=statistics,health_personnel.
Eley BM The future of dental amalgam: a review of the literature. Part 6: Possible harmful effects of mercury from dental amalgam. Br Dent J 1997; 182: 455–459.
Ahlqwist M, Bengtsson C, Lapidus L Number of amalgam filings in relation to cardiovascular disease, diabetes, cancer and early death in Swedish women. Community Dent Oral Epidemiol 1993; 21: 40–44.
Ahlqwist M, Bengtsson C, Lapidus L et al. Concentrations of blood, serum and urine components in relation to number of amalgam tooth filings in Swedish women. Community Dent Oral Epidemiol 1995; 23: 217–221.
Björkman L, Pedersen NL, Lichtenstein P Physical and mental health related to dental amalgam fillings in Swedish twins. Community Dent Oral Epidemiol 1996; 24: 260–267.
Saxe SR, Wekstein MW, Kryscio RJ et al. Alzheimer's disease, dental amalgam and mercury. JADA 1999; 130: 191–199.
Langworth S, Sallsten G, Barregard L et al. Exposure to mercury vapor and impact on health in the dental profession in Sweden. J Dent Res 1997; 76: 1397–1404.
Rowland S, Baird DD, Weinberg CR et al. The effect of occupational exposure to mercury vapour on the fertility of female dental assistants. Occup Environ Med 1994; 51: 28–34.
Murtomaa H, Holttinen T, Meurman JH Conceptions of dental amalgam and oral health aspects during pregnancy in Finnish women. Scand J Dent Res 1991; 99: 522–526.
Thomson WM, Stewart JF, Carter KD et al. The Australian public's perception of mercury risk from dental restorations. Community Dent Oral Epidemiol 1997; 25: 391–395.
Acknowledgements
This study was based in part on data from the National Health Insurance Research Database provided by the Bureau of National Health Insurance, Department of Health and managed by National Health Research Institutes. The interpretation and conclusions contained herein do not represent those of Bureau of National Health Insurance, Department of Health or National Health Research Institutes.
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Hu, SW., Yang, LC. & Chang, HY. Factors associated with amalgam restorations in Taiwan. Br Dent J 193, 411–414 (2002). https://doi.org/10.1038/sj.bdj.4801577
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DOI: https://doi.org/10.1038/sj.bdj.4801577
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