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Objective: To measure the 5-year caries increment among high-risk children during their participation in the New England Children’s Amalgam Trial (NECAT), and to evaluate sociodemographic factors that may account for any observed disparities. Methods: NECAT recruited 534 children aged 6–10 with at least two decayed posterior occlusal surfaces from urban Boston and rural Maine. After restoration of baseline caries and application of sealants to sound surfaces, NECAT continued to provide free comprehensive semiannual dental care to participants. The net caries increment of children who completed the 5-year follow-up ( n = 429) was calculated and predictors of caries increment were investigated using multivariate negative binomial models. Results: The majority of children (89%) experienced new caries by the end of the 5-year follow-up. Almost half (45%) had at least one newly decayed surface by the first annual visit. At year 5, the mean number of new decayed teeth was 4.5 ± 3.6 (range 0–25) and surfaces was 6.9 ± 6.5 (range 0–48). Time trends showed a noticeably higher increment rate among older children and young teenagers. Multivariate models showed that age ( P < 0.001), number of baseline carious surfaces ( P < 0.001), and toothbrushing frequency (<1/day versus ≥2/day, P = 0.04) were associated with caries increment. Only 48 children (11%) did not develop new caries. Conclusions: Despite the receipt of comprehensive semiannual dental care, the vast majority of these high-risk children continued to develop new caries within 5 years. While disparities were observed by age, extent of prior decay, and toothbrushing frequency, no other sociodemographic factors were associated with caries increment, suggesting that the dental care provided during the trial reduced sociodemographic disparities in prior caries experience that were observed at baseline. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to assess the relationship between baseline caries experience and the restoration replacement rate in children. Methods: The 5-year New England Children's Amalgam Trial recruited 534 6- to 10-year-old children with 2 or more carious posterior teeth. The association between decay and longevity of restorations was assessed. Restorations with no follow-up (N=391) were excluded from analysis. Results: The average follow-up was 3.0±1.6 years in 489 children. Restorations with fallow-up (N=3,604) were placed in mouths with a median of 15 dfs/DFS and 8 dft/DFT The need for replacement increased significantly (P≤.001) with increasing numbers of dfs/DFS and dft/DFT After 5 years of follow-up, at least 15% of restorations in a mouth with ≥14 dfs/DFS needed replacement, compared to 9% for 2 to 5 dfs/DFS. Comparing dft/DFT after 5 years of follow-up, there was a 23% replacement rate far >12 dft/DFT compared to 10% for 2 to 3 dft/DFT Decay in the mouth had a greater association with the need for replacement due to new caries compared to replacement due to recurrent caries. Conclusion: Children with more decay at the time of restoration placement were at higher risk for replacement of restorations. [ABSTRACT FROM AUTHOR]