507 Use of ART in posterior primary teeth: a conjoint analysis

Thursday, March 22, 2012: 3:30 p.m. - 4:45 p.m.
Presentation Type: Poster Session
E. KATEEB1, J. WARREN2, G. GAETH3, P. DAMIANO4, M. KANELLIS5, E. MOMANY6, K. WEBER-GASPARONI5, and T. ANSLEY7, 1University of Iowa, Dublin, OH, 2Prev. & Comm. Dentistry, University of Iowa, Iowa City, IA, 3Department of Marketing, University of Iowa, Iowa City, IA, 4Public Policy Center and Preventive and Community Dentistry, University of Iowa, Iowa City, IA, 5Department of Pediatric Dentistry, University of Iowa, Iowa City, IA, 6Public Policy Center, University of Iowa, Iowa City, IA, 7Psychological and Quantitative Foundations, University of Iowa, Iowa City, IA
Objectives: Many organizations worldwide endorse the use of Atraumatic Restorative Treatment (ART) as a means of restoring caries in populations that have little access to traditional dental care or for patients for whom traditional treatment is not feasible. The little information available about ART in the US indicates that ART is used more in anterior teeth. In this study, we investigate factors that influence the use of ART in posterior teeth in children.

Methods: A conjoint survey was sent to a random sample of 2247 members registered as specialists by the American Academy of Pediatric Dentistry. We identified three factors (age of the child, level of cooperation, type of insurance) and varied each across three levels to create a nine cell conjoint design (9 clinical scenarios). We were then able to elicit weights practitioners place on these factors. Lesion location, depth and extension were fixed in the nine clinical scenarios.

Results: 707 (31%) pediatric dentists completed the survey. Child’s cooperation had the biggest impact on pediatric dentists' decisions to use ART (72 %) compared to child’s age (23 %) and type of insurance coverage (7 %). For the age factor, age of three years had the greatest utility (0.27) compared to age 8 (-0.167). For types of insurance coverage, having no insurance (0.073) had the greatest utility compared to having public insurance (-0.082). 

Conclusions: Conjoint Analysis is a valid procedure to show the relative importance practitioners place on different factors that may influence their decision to use ART. Overall, uncooperativeness was a strong predictor of ART use in the posterior teeth. Although insurance coverage was the least important factor overall, having public insurance made pediatric dentists more reluctant to use ART in children in this conjoint analysis.

This abstract is based on research that was funded entirely or partially by an outside source: This project was funded by NIH/NIDCR T32 grant DEO 14678-06

Keywords: ART, Assessment, Caries and Teeth