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American Academy of Pediatrics
Article

Dental Composite Restorations and Psychosocial Function in Children

Nancy N. Maserejian, Felicia L. Trachtenberg, Russ Hauser, Sonja McKinlay, Peter Shrader, Mary Tavares and David C. Bellinger
Pediatrics August 2012, 130 (2) e328-e338; DOI: https://doi.org/10.1542/peds.2011-3374
Nancy N. Maserejian
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Felicia L. Trachtenberg
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Russ Hauser
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Sonja McKinlay
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Peter Shrader
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Mary Tavares
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David C. Bellinger
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Abstract

BACKGROUND AND OBJECTIVE: Resin-based dental materials may intraorally release their chemical components and bisphenol A. The New England Children’s Amalgam Trial found that children randomized to amalgam had better psychosocial outcomes than those assigned to composites for posterior tooth restorations. The objective of this study was to examine whether greater exposure to dental composites is associated with psychosocial problems in children.

METHODS: Analysis of treatment-level data from the New England Children’s Amalgam Trial, a 2-group randomized safety trial comparing amalgam with the treatment plan of bisphenol A-glycidyl methacrylate (bisGMA)-based composite and urethane dimethacrylate–based polyacid-modified composite (compomer), among 534 children aged 6 to 10 years at baseline. Psychosocial function at follow-up (n = 434) was measured by using the self-reported Behavior Assessment System for Children (BASC-SR) and parent-reported Child Behavior Checklist (CBCL).

RESULTS: Children with higher cumulative exposure to bisGMA-based composite had poorer follow-up scores on 3 of 4 BASC-SR global scales: Emotional Symptoms (β = 0.8, SE = 0.3, P = .003), Clinical Maladjustment (β = 0.7, SE = 0.3, P = .02), and Personal Adjustment (β = –0.8, SE = 0.2, P = .002). Associations were stronger with posterior-occlusal (chewing) surfaces, where degradation of composite was more likely. For CBCL change, associations were not statistically significant. At-risk or clinically significant scores were more common among children with greater exposure for CBCL Total Problem Behaviors (16.3% vs 11.2%, P-trend = .01) and numerous BASC-SR syndromes (eg, ≥13 vs 0 surface-years, Interpersonal Relations 13.7% vs 4.8%, P-trend = .01). No associations were found with compomer, nor with amalgam exposure levels among children randomized to amalgam.

CONCLUSIONS: Greater exposure to bisGMA-based dental composite restorations was associated with impaired psychosocial function in children, whereas no adverse psychosocial outcomes were observed with greater urethane dimethacrylate–based compomer or amalgam treatment levels.

KEY WORDS
  • composite dental resin
  • composite resins
  • bisphenol A-glycidyl methacrylate
  • compomers
  • child behavior
  • behavioral symptoms
  • affective symptoms
  • Abbreviations:
    BASC-SR —
    Behavior Assessment for Children–Self-Report
    bisGMA —
    bisphenol A-glycidyl methacrylate
    BPA —
    bisphenol A
    CBCL —
    Child Behavior Checklist
    NECAT —
    New England Children’s Amalgam Trial
    UDMA —
    urethane dimethacrylate
    • Accepted April 10, 2012.
    • Copyright © 2012 by the American Academy of Pediatrics

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    Pediatrics
    Vol. 130, Issue 2
    1 Aug 2012
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    Dental Composite Restorations and Psychosocial Function in Children
    Nancy N. Maserejian, Felicia L. Trachtenberg, Russ Hauser, Sonja McKinlay, Peter Shrader, Mary Tavares, David C. Bellinger
    Pediatrics Aug 2012, 130 (2) e328-e338; DOI: 10.1542/peds.2011-3374

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    Dental Composite Restorations and Psychosocial Function in Children
    Nancy N. Maserejian, Felicia L. Trachtenberg, Russ Hauser, Sonja McKinlay, Peter Shrader, Mary Tavares, David C. Bellinger
    Pediatrics Aug 2012, 130 (2) e328-e338; DOI: 10.1542/peds.2011-3374
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