187 - SDF utilization on posterior dentition in pediatric dentistry

Purpose: The purpose of this study is to determine how SDF is currently being utilized by practicing pediatric dentists in the US on posterior dentition. The secondary aim is to determine if there are differences in utilization based on years in practice and practice setting.

Methods: A survey was sent out via email to active American Academy of Pediatric Dentistry (AAPD) members. The survey includes questions regarding provider demographics and how SDF is being utilized in practice.

Results: The 19-question survey was sent out to 6,654 active members of the AAPD. Six hundred sixty-six members voluntarily took the survey (10% response rate). Of these respondents, 638 were actively practicing dentists. Current residents, retired dentists and those not currently practicing were excluded, leaving 623 study participants. Not all participants completed each question of the survey.

Discussion: Of the actively practicing dentists that responded, 39% have been practicing less than 10 years and 61% have been practicing greater than 10 years. The majority of respondents report using SDF in practice, with only 4.8% reporting never using SDF (Figure 1). More than half of respondents (60%) report using SDF frequently, defined as weekly or more often.
Dentists who have been practicing fewer years (≤10) use SDF more frequently as compared to those who have been practicing longer (>10 years): 66% vs. 55%; p=0.007.
Dentists practicing in urban and rural areas use SDF more frequently as compared to suburban area: 62% and 78%, respectively vs. 55%; p<0.001.
Within a dental office, there are multiple people that can apply SDF. Each state also has different regulations about who can apply the product. Of the respondents, a majority report that the dentist applies SDF (81.5%). The remaining 18.5% or respondents reported that other staff, including dental hygienists or dental assistants, apply SDF.
Reimbursement for application of SDF can vary greatly: 9.5% report not receiving any reimbursement for SDF application, 79% report receiving up to $50 per tooth for SDF application, and 11.5% report receiving greater than $50 per tooth for SDF application.
There are multiple indications for SDF application. The most common indications were occlusal and interproximal caries in primary molars (94.4% and 84.9% respectively). Fewer, but still a majority of respondents, used SDF for occlusal and interproximal caries in permanent molars (70.4% and 62.9% respectively). The least frequently selected indication for usage are on non-carious surfaces on both primary and permanent teeth.

Conclusion: SDF is an acceptable treatment option for most pediatric dentists surveyed. Study results support the first hypothesis: dentists who have been practicing for fewer (≤10) years use SDF more frequently. This may be attributed to SDF becoming a treatment option within the last 10 years.
Study results also support the second hypothesis: dentists practicing in urban & rural areas use SDF more frequently. Further research is needed to conclude why the difference in usage occurs due to these demographic variables.
Because there is a large variability in what is considered indications for SDF usage by pediatric dentists that participated in this study, future research is needed to determine what are the most proven indications for SDF use.