Declining US dental amalgam restorations in US Food and Drug Administration-identified populations: 2017-2023.
Dental amalgam
United States
dental restoration
disparities
mercury
Journal
Journal of the American Dental Association (1939)
ISSN: 1943-4723
Titre abrégé: J Am Dent Assoc
Pays: England
ID NLM: 7503060
Informations de publication
Date de publication:
06 Sep 2024
06 Sep 2024
Historique:
received:
10
01
2024
revised:
24
06
2024
accepted:
19
07
2024
medline:
7
9
2024
pubmed:
7
9
2024
entrez:
7
9
2024
Statut:
aheadofprint
Résumé
In light of the Minamata Convention on Mercury and efforts to phase down dental amalgam use, tracking dental amalgam proportions across US Food and Drug Administration (FDA)-identified at-risk populations is of interest to optimize material selection aligned with patient needs. A retrospective observational study of Epic's Cosmos electronic health records data set was conducted to calculate the rates of dental amalgam restorations from 2017 through 2023 and stratified using the social vulnerability index (quartile 4 indicates the highest social vulnerability and quartile 1 indicates the lowest) and payer type (Medicare, Medicaid, self-pay, miscellaneous or other). The authors included the following FDA-identified at-risk populations: pregnant people, children younger than 6 years, people with preexisting neurologic conditions, and people with impaired kidney function (n = 1,897,976). The overall rate of dental amalgam restoration placements in the general population declined from 21.8% in 2017 to 4.1% in 2023. Dental amalgam restoration trends, according to social vulnerability index quartile and payer type, decreased consistently across all 4 evaluated populations. Of all the social vulnerability index quartiles, quartile 4, representing the most socially vulnerable group, had the smallest decrease in dental amalgam placement rates among the FDA-identified populations examined. The study results showed a decreasing trend in dental amalgam restorations from 2017 through 2023 among FDA-identified populations, consistent with the Minamata Convention on Mercury directive for a phasedown in dental amalgam use. Notwithstanding improvements, lingering disparities persist among the most vulnerable population. Even within the groups identified as most vulnerable to harm, more targeted interventions and strategies are required to improve treatment among the most socially vulnerable.
Sections du résumé
BACKGROUND
BACKGROUND
In light of the Minamata Convention on Mercury and efforts to phase down dental amalgam use, tracking dental amalgam proportions across US Food and Drug Administration (FDA)-identified at-risk populations is of interest to optimize material selection aligned with patient needs.
METHODS
METHODS
A retrospective observational study of Epic's Cosmos electronic health records data set was conducted to calculate the rates of dental amalgam restorations from 2017 through 2023 and stratified using the social vulnerability index (quartile 4 indicates the highest social vulnerability and quartile 1 indicates the lowest) and payer type (Medicare, Medicaid, self-pay, miscellaneous or other). The authors included the following FDA-identified at-risk populations: pregnant people, children younger than 6 years, people with preexisting neurologic conditions, and people with impaired kidney function (n = 1,897,976).
RESULTS
RESULTS
The overall rate of dental amalgam restoration placements in the general population declined from 21.8% in 2017 to 4.1% in 2023. Dental amalgam restoration trends, according to social vulnerability index quartile and payer type, decreased consistently across all 4 evaluated populations. Of all the social vulnerability index quartiles, quartile 4, representing the most socially vulnerable group, had the smallest decrease in dental amalgam placement rates among the FDA-identified populations examined.
CONCLUSIONS
CONCLUSIONS
The study results showed a decreasing trend in dental amalgam restorations from 2017 through 2023 among FDA-identified populations, consistent with the Minamata Convention on Mercury directive for a phasedown in dental amalgam use. Notwithstanding improvements, lingering disparities persist among the most vulnerable population.
PRACTICAL IMPLICATIONS
CONCLUSIONS
Even within the groups identified as most vulnerable to harm, more targeted interventions and strategies are required to improve treatment among the most socially vulnerable.
Identifiants
pubmed: 39243252
pii: S0002-8177(24)00397-0
doi: 10.1016/j.adaj.2024.07.015
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 American Dental Association. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Disclosure None of the authors reported any disclosures.