The willingness of US pediatric dentists to use atraumatic restorative treatment (ART) with their patients: a conjoint analysis

Objectives:Theatraumaticrestorativetreatment(ART)wasdevelopedasanaffordable, patient-friendly dental caries management procedure that does not need extensive operator training or special skills. The aim of this study was to determine factors that influence the decision to use ART using an innovative marketing research technique known as conjoint analysis. Methods: A conjoint survey was completed by 723 members of the American Academyof PediatricDentistry.Threefactors(ageof thechild,levelof cooperation, type of insurance) were varied across three levels to create nine patient scenarios. The weights that practitioners placed on these factors in decisions to use ART in treating carious lesions were determined by conjoint analysis.Factors such as lesion location,depth,and extension werefixed in the nine clinical scenarios. Results: Seven-hundred twenty-three pediatric dentists completed the survey (32 percent).Age of the child was the most important factor in pediatric dentists’ decisions to use ART (46 percent) compared with level of cooperation (41 percent) and typeof insurancecoverage(11percent).Fortheagefactor,theageof 2yearshadthe greatest utility (0.55) compared with age 4 (−0.09) and age 6 (−0.46). For types of insurance coverage, having no insurance (0.124) had the greatest utility compared with having public insurance (−0.119). Conclusions: Although insurance coverage was the least important among the factors, being without insurance, being very young, and being uncooperative was the scenario where pediatric dentists most favored ART when making trade offs between different factors using the conjoint design.