Analysis of Trends in Treatments of Approximal Lesions

Objective: Analyze the trends in treatment of approximal lesions over 32 months using ICDAS criteria. Methods: 569 children, ranging in age from 5 to14 yrs old, from 3 rural schools in Puerto Rico were consented and examined using ICDAS at baseline and at four-month intervals up to 32 months. Every four months each subject was given a referral for their dentist. Results: Results obtained from the data, collected through 32 months, show findings of 567 caries lesions with an ICDAS score >= 3 on approximal surfaces. During this 32 month period no fillings were observed in 481 (85%) of the lesions. In teeth with mesial (M), distal (D) or mesial and distal (MD) lesions, which did not present an occlusal (O) lesion, only 30 (15%) were filled. In 7 (23%), of the 30 teeth, only the occlusal surface was filled where no previous occlusal lesion was present. Data shows that in teeth with MO, DO, and MOD lesions, 56 teeth (15%) were restored. In 15 (27%) of teeth that presented MO, DO or MOD only the occlusal surface was filled. Findings for teeth with ICDAS score >= 1 show 2353 approximal lesions of which 2021 (86%) were not restored. Data shows 855 teeth presenting M, D, MD lesions and no occlusal lesions. Of these, 89 (10%) presented fillings and 32 (36%) of these fillings were done on the occlusal surface, which presented no previous lesion. Of the 1498 teeth with MO, DO and MOD lesions, 243 (16%) presented fillings. Of these 161 (66%) had fillings in only the occlusal surface. Conclusion: Data collected shows teeth with lesions ICDAS >= 1 and ICDAS >= 3 were not treated. Those that were treated showed a marked tendency to fill only the occlusal and not the approximal lesions. Supported by NIH/NIDCR RO1DE017890-03