Associations between dental treatment in the primary and permanent dentitions using insurance claims data.

PURPOSE The purpose of this study was to assess the associations between dental treatment in the early primary dentition and later treatment in the primary and permanent teeth. METHODS Delta Dental Plan of Michigan insurance claims data on 9,886 children who were born in 1990 and were covered by dental insurance from 1990-1998 were used. Risk ratios (RR), screening test measures of sensitivity (SN) and specificity (SP), and evidence-based dentistry research measures of Likelihood Ratio (LR) and Number Needed to Treat (NTT) were calculated. RESULTS Primary anterior tooth treatment at ages 0-3 was weakly associated (RR = 1.43, 95% C.I. = 1.23, 1.65) with treatment of the permanent first molars at ages 6-8 and had SN, SP, LR, and NNT values of 7.4, 95.3, 1.57, and 12 respectively. Primary posterior tooth treatment at ages 4-8 was more strongly associated with future permanent first molar treatment with a RR of 2.44 (95% C.I. = 2.26, 2.64) and SN, SP, LR, and NNT values of 65.9, 61.7, 1.72, and 6. CONCLUSIONS For this population, early childhood treatment in the primary anterior teeth was a weak predictor of future permanent first molar treatment. Primary posterior teeth treatment, while still not a strong predictor, was better than primary anterior teeth in predicting permanent tooth treatment. Caries treatment at ages 4-8 in the primary teeth was better than treatment at ages 0-3 in predicting permanent first molar treatment.