88 - Caries Relapse and Full-Mouth Rehabilitation

Abstract:

Purpose: The aim of this retrospective chart review is to determine the rate of early childhood caries relapse over two years among a sample of children who underwent full-mouth dental rehabilitation in the operating room (OR) at Columbia NewYork-Presbyterian.

Methods: All data were abstracted from Epic electronic health records for non-medically complex children (ASA I/II) six years old and under who underwent dental rehabilitation in the OR between January 2020 to September 2023. Caries relapse, defined as any caries incidence at the tooth- or surface-level over two years post-OR treatment, was assessed by evaluating the total number of teeth and tooth surfaces affected by caries at each follow-up visit. Additional data analyzed as potential explanatory variables include patients’ recall visit attendance (at 6-month, 1- and 2-year follow-up appointments), dental visit history (e.g., number of regular and non-traumatic emergency visits), number of appointment cancellations, and self-reported use of fluoride toothpaste.

Results: Among 87 patients attending at least one recall visit, 63.2% experienced caries relapse, increasing from 51% at 6 months to 57% at 12 months and 62% at 24 months. Age, race, ethnicity, language, fluoride toothpaste use, emergency visits, and cancellations were not significantly associated with relapse. These findings suggest children requiring rehabilitation under GA remain at high risk for recurrence and highlight the need for improved follow-up. These findings are consistent with prior studies reporting caries recurrence as early as six months after GA. Implementing automated reminders, strengthening pre-operative oral hygiene education, and incorporating incentive-based strategies may improve recall attendance and support long-term disease management. Limitations include the retrospective design, reliance on clinical documentation, and potential variability in provider caries diagnosis.

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