Key Points
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The paper presents a retrospective analysis of the outcome of the non-restoration of carious deciduous teeth.
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Multi-surface cavities presenting early in lower molar teeth were most likely to produce pain or infection.
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A pain-predictive model is generated from the data analysis.
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The model may provide a basis for further development.
Abstract
Objective To provide a pain-predictive model for the non-operative management of carious deciduous teeth from the analysis of data from a retrospective analysis of clinical case notes of children regularly attending two general dental practices and receiving preventive care.
Design A clearly defined protocol was used to determine the fate of deciduous teeth diagnosed as carious into dentine but symptomless and left unrestored from the sequential examination of the clinical records of 480 children attending at least annually.
Results The age of the children at the first visit when carious teeth were diagnosed ranged from 008 to 12.3 years, with the majority of children (243/480) presenting by 6 years of age. In all, 250 teeth from 162 children were extracted because of pain or became painful and were treated. The remaining 318 children did not report pain on subsequent visits. The strongest predictor of pain was age on diagnosis, the other factors being tooth type and extent of the cavity when first seen. Data from the present study provides a model that enables a child with deciduous caries to be placed into one of six pain-predictive groups associated with a risk of pain or infection if the teeth are not restored but provided with preventive care only.
Conclusion In these patients, the majority of unrestored carious deciduous teeth remain symptomless until shed. A higher risk of subsequent pain or infection was associated with the development of caries in younger patients, disease extending beyond single surfaces, and disease in lower deciduous molars. The results provide evidence to aid the treatment planning of carious deciduous teeth in children receiving regular preventive dental care.
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Acknowledgements
The authors are grateful to Mrs. Carol-ann Levine and Mrs. Kathryn Hopkins for their assistance. This study was supported by a grant from the Shirley Glaston Hughes Memorial Fund, which is gratefully acknowledged.
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Levine, R., Nugent, Z. & Pitts, N. Pain prediction for preventive non-operative management of dentinal caries in primary teeth in general dental practice. Br Dent J 195, 202–206 (2003). https://doi.org/10.1038/sj.bdj.4810444
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DOI: https://doi.org/10.1038/sj.bdj.4810444
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