The Occurrence of Dental Pain and Extractions over a 3-Year Period in a Cohort of Children Aged 3-6 Years

Objectives: To describe the occurrence of dental pain and extractions in young children in relation to the caries and restoration history of their primary molar teeth. Methods: A prospective cohort study of 739 children aged 2.8 to 6.2 years attending 50 dental practices in the North West of England followed for 3 years. Incidence rates for pain and extraction in primary molar teeth were calculated for children with and without dental caries. Tooth years at risk of extraction or pain were calculated for each primary molar according to whether they were caries-free, carious and unrestored, or restored. Results: A total of 119 (16.1 percent) children had caries at recruitment and 157 developed caries during follow-up. Each year approximately one in five children with caries, but only one in 100, who was caries-free, presented with dental pain. In the whole population, each year, approximately one in 40 children had a primary molar tooth extracted but in children with caries it was one in 10. In the total cohort, incidence of pain was higher in unrestored carious teeth than restored, but incidence of extraction was higher in restored than in unrestored teeth. Conclusion: The majority of children attending general dental practice remained caries-free and did not experience pain or extraction over 3 years. Children with caries had a substantial risk of developing pain or having an extraction. The study was unable to demonstrate that restoring carious primary molar teeth prevents pain and extraction.