Dental sealants and flowable composite restorations and psychosocial, neuropsychological, and physical development in children.
OBJECTIVE
Dental sealant materials may intraorally release their components, including bisphenol-A (BPA), but long-term health effects are uncertain. The New England Children's Amalgam Trial (NECAT) found that composite restorations were associated with psychosocial, but not neuropsychological or physical, outcomes. The previous analysis did not consider sealants and preventive resin restorations (PRRs), which were routinely placed. The purpose of this analysis was to examine sealant/PRR exposure in association with psychosocial and other health outcomes.


METHODS
NECAT recruited 534 six- to 10-year-olds and provided dental care during a five-year follow-up. Annually, examiners conducted psychosocial and neuropsychological tests and measured body mass index (BMI) and fat percentage (BF%). Associations between surface years (SY) of sealants/PRRs and outcomes were tested using multivariable models.


RESULTS
Cumulative exposure level to sealants and/or PRRs was not associated with psychosocial assessments (eg, total problems: Child Behavior Checklist, 10-SY β=-0.2 ± 0.3, P=.60) or neuropsychological tests (eg, full-scale IQ, 10-SY β=0.1 ± 0.2, P=.60). There were no associations for changes in BMI-for-age z-score (P=.40), BF% (girls 10-SY β=-0.2 ± 0.3; boys 10-SY β=-0.1 ± 0.3), or menarche (10-SY hazard ratio=0.91, 95% confidence interval=0.83-1.01, P=.08).


CONCLUSIONS
This study showed no associations between exposure level of dental sealants or PRRs and behavioral, neuropsychological, or physical development in children over 5-years.
Senior research scientist and an associate director, Department of Epidemiology, New England Research Institutes, Watertown, and Lecturer, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Mass., USA. nmaserej@post.harvard.edu.
Nancy N
NN
Maserejian
Statistician, and Massachusetts General Hospital, Boston, Mass., USA.
Peter
P
Shrader
Senior statistician, New England Research Institutes, and Massachusetts General Hospital, Boston, Mass., USA.
Felicia L
FL
Trachtenberg
Professor, Harvard School of Public Health, Harvard Medical School, and Massachusetts General Hospital, Boston, Mass., USA.
Russ
R
Hauser
Professor, Harvard School of Public Health, Boston Children's Hospital, and Harvard Medical School, Boston, Mass., USA.
David C
DC
Bellinger
Program director, Advanced Graduate Education Program in Dental Public Health, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, and a senior clinical investigator, The Forsyth Institute, Cambridge, Mass., USA.
Mary
M
Tavares
D017438:Bisphenol A-Glycidyl Methacrylate / Q000737:chemistry; D050218:Body Fat Distribution; D015992:Body Mass Index; D002648:Child; D002652:Child Behavior / Q000187:drug effects; D002657:Child Development / Q000187:drug effects; D015331:Cohort Studies; D020770:Compomers / Q000737:chemistry; D003188:Composite Resins / Q000737:chemistry* / Q000627:therapeutic use; D003764:Dental Materials / Q000737:chemistry*; D003793:Dental Restoration, Permanent / Q000145:classification*; D004781:Environmental Exposure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D008572:Menarche / Q000187:drug effects; D009483:Neuropsychological Tests; D010895:Pit and Fissure Sealants / Q000627:therapeutic use*; D002666:Psychology, Child; D012822:Silicon Dioxide / Q000737:chemistry; D015040:Zirconium / Q000737:chemistry
D020770:Compomers; D003188:Composite Resins; D003764:Dental Materials; C477384:Dyract Flow Compomer; D010895:Pit and Fissure Sealants; C102735:Revolution (composite resin); C106663:Ultra Seal XT; C083568:Z100 composite resin; C111840:flowable hybrid composite; D017438:Bisphenol A-Glycidyl Methacrylate; D012822:Silicon Dioxide; D015040:Zirconium