254 - Utilization of Amalgam or Composite Resin in Pediatric Dental Restorations

Purpose: Advancements in dental materials and changing parental preferences are modifying the frequency of use of restorative materials. This data claims analysis examined the trends in utilization of amalgam and resin composite in the United States.

Methods:  Commercial dental insurance claims were used to compare 505,994 restorations, corresponding with CDT codes for 1/2/3 surface amalgam or resin restorations. Paid claims collected nationwide from January 2010 up to March 2020 were analyzed. Data for children 3-12 years old were used, resulting in 219,632 unique patient IDs. GEE models applied to logistic regression were used. A two-sided 5% significance level was used for all tests.

Results: In general, female patients were less likely to receive amalgam than males. The likelihood of having an amalgam restoration placed was inversely correlated with income. Pediatric dentists were not as likely as general dentists to utilize amalgam. More surfaces in a restoration was associated with higher probability of amalgam placement. Percent of amalgam restorations was higher for 2010 than 2011-2020, in 2011 than 2012-2020, and this pattern recurred in several of the years analyzed, though some years showed differences that were not significant. In general, patient age at time of amalgam restoration increased over time, and younger patients received less amalgam restorations.

Conclusion: The use of dental amalgam is trending down; the sharpest decline was noted in 2014. Pediatric dentists were less likely to utilize amalgam than general dentists. Females and patients with higher SES were less likely to have amalgam.