Comments on: Filling trauma, new study finds fillings are rotting teeth

By: stuartwolf2@bigpond.com

stuartwolf2@bigpond.com — Sat, 31 Oct 2015 05:03:34 +0000

I have come to the same conclusions as Kostas , Tony and John , even before reading their posts. Too many articles using so called evidence based research end up producing inferences contrary to what the research indicates. Clinical advice is still the best.

By: John

John — Fri, 30 Oct 2015 03:25:23 +0000

I agree entirely Kostas.
I believe this study has been hijacked and the stupid conclusions were drawn purely for sensationalism. The public know nothing about tooth decay but they love to read anything that gives them the excuse to avoid visiting a dentist, or even bothering to brush their teeth for that matter.
I will throw this article in the bin with the anti-fluoride quackery and other ideas spreading ignorance.

By: Tony Hughes

Tony Hughes — Fri, 30 Oct 2015 01:10:52 +0000

I find the title of this article misleading and the conclusions strange.

I my experience, if tooth decay occurs on one surface between teeth, there is a high risk of tooth decay forming on the adjacent tooth due to the same factors that lead to the decay in the first place. Leaving the tooth decay untreated leads to loss of the tooth or expensive and more invasive treatments such as root canal therapy. Untreated tooth decay will lead to increased risk of tooth decay in the adjacent tooth.

Fillings do not cause tooth decay. Operator error would predispose further tooth decay, but this is an obvious conclusion. If a dentist accidentally drills a hole into a tooth, of course it will be in risk of decay. The incidence of a skilled dentist having this happen is low.

By: Kostas

Kostas — Fri, 30 Oct 2015 00:08:36 +0000

Interesting to read this but I have reservations about the study. The original article can be found here: http://www.sciencedirect.com/science/article/pii/S0300571215300385
Some key points about this paper that were not mentioned in the summary above and may be misleading to a member of the public who happens to come across this on a simple Google search and become concerned are as follows. 1) Interproximal caries incidence was the dependent variable. There are multiple risk factors for smooth surface caries, the dental practitioner placing a restoration on an adjacent tooth is not likely to be high on the list. For this reason, the title on this news feed is misleading. 2) Inclusion criteria for this study required patients to be <17 years to permit 4-5 year follow-up. Again, caries risk is high in this population and it is clear that incidence of caries reduces with age so the results of this study may not be applicable to adult populations. Again, there was no mention of the sample being children or young adults in the synopsis above. 3) 44.4% of the teeth had enamel-surface caries at baseline and of those, ~40% developed into dentine or were restored during the follow-up period. The only statistically significant risk factor OR [95%CI] 1.06 [1.00, 1.13], P=0.04 following adjustment for confounding in this group was having a high DMFT index to start with. To put it plainly, the people who developed more decay during the follow-up period started off by having a greater caries experience and this risk was 6% higher compared to those who had a low DMFT. Additionally, the lower limit of the 95% confidence interval relating to this odds ratio is 1.00 (meaning that it is absolutely possible that there is no increased risk) compared to having lower DMFT at baseline.
I could go on much longer about this study but I would like to conclude by stating that as a medium for disseminating information to dental clinicians and the general public, caution must be used when interpreting research findings. We don't need the public avoiding accessing dental services because they fear visiting will do them harm.