title: A preliminary study applying decision analysis to the treatment of caries in primary teeth.
abstract: OBJECTIVE
  To determine an optimal treatment strategy for carious deciduous teeth.
  
  
  METHODS
  Manchester Dental Hospital.
  
  
  METHODS
  Decision analysis.
  
  
  METHODS
  The likelihoods of each of the sequelae of caries in deciduous teeth were determined from the literature. The utility of the outcomes from non-treatment and treatment was then measured in 100 parents of children with caries, using a visual analogue scale. Decision analysis was performed which weighted the value of each potential outcome by the probability of its occurrence. A decision tree "fold-back" and sensitivity analysis then determined which treatment strategies, under which circumstances, offered the maximum expected utilities.
  
  
  RESULTS
  The decision to leave a carious deciduous tooth unrestored attracted a maximum utility of 76.65 and the overall expected utility for the decision "restore" was 73.27 The decision to restore or not restore carious deciduous teeth are therefore of almost equal value. The decision is however highly sensitive to the utility value assigned to the advent of pain by the patient.
  
  
  CONCLUSIONS
  There is no clear advantage to be gained by restoring deciduous teeth if patients' evaluations of outcomes are taken into account. Avoidance of pain and avoidance of procedures which are viewed as unpleasant by parents should be key determinants of clinical decision making about carious deciduous teeth.
authors.affiliation: Dental practice, Amicus Dentis, Ševčenkos 12-31, Vilnius, Lithuania. vytautast@hotmail.com.
authors.forename: Vytautas
authors.initials: V
authors.lastname: Tamošiūnas
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kay
authors.forename: Rebecca
authors.initials: R
authors.lastname: Craven
mesh_terms: D001294:Attitude to Health; D002648:Child; D002675:Child, Preschool; D003661:Decision Support Techniques; D003731:Dental Caries / Q000150:complications / Q000628:therapy*; D003793:Dental Restoration, Permanent; D006801:Humans; D016013:Likelihood Functions; D017063:Outcome Assessment, Health Care; D010290:Parents / Q000523:psychology; D010347:Patient Care Planning; D011336:Probability; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014080:Tooth Exfoliation; D014094:Tooth, Deciduous / Q000473:pathology*; D014098:Toothache / Q000150:complications; D064232:Visual Analog Scale