title: Dental sealants and restorations and urinary bisphenol A concentrations in children in the 2003-2004 National Health and Nutrition Examination Survey.
abstract: BACKGROUND
  Resin-based dental sealants and composites contain bisphenol A-glycidyl methacrylate, a bisphenol A (BPA) derivative. The authors hypothesized that a greater number of sealants or restorations would be associated with higher urinary BPA concentrations.
  
  
  METHODS
  The authors examined urinary BPA measurements (in nanograms per milliliter) and oral examination data for 1,001 children aged 6 to 19 years from data sets of the 2003-2004 National Health and Nutrition Examination Survey (NHANES). They categorized children according to number of occlusal sealants and number of restorations, with four categories in each of the two groups. They estimated associations by using unadjusted and adjusted tobit regression models.
  
  
  RESULTS
  The lowest quartile of BPA concentrations ranged from 0.3 ng/mL to 1.9 ng/mL, whereas the highest quartile ranged from 7.3 ng/mL to 149 ng/mL. In adjusted analysis, children with seven to 16 sealants had geometric mean BPA concentrations 25 percent higher than those of children with no sealants (95 percent confidence interval [CI], -14 percent to 82 percent; P = .23). In adjusted analysis, children with seven to 42 restorations had geometric mean BPA concentrations 20 percent higher than those of children with no restorations (95 percent CI, -6 percent to 53 percent; P = .13). Neither of these adjusted estimates was statistically significant.
  
  
  CONCLUSIONS
  Though the findings were in the direction hypothesized, the authors did not observe a statistically significant association between a greater number of sealants or restorations and higher urinary BPA concentrations. Additional studies are needed to determine the extent of oral and systemic exposure to BPA from resin-based dental restorative materials over time.
  
  
  CONCLUSIONS
  Dentists should follow this issue carefully as it develops and as the body of evidence grows. There is insufficient evidence to change practice at this time.
authors: Dr. McKinney is an acting assistant professor, Department of Oral Health Sciences, University of Washington, Box 357475, Seattle, Wash. 98195, e-mail chrismck@uw.edu. Address correspondence to Dr. McKinney.
authors: Christy
authors: C
authors: McKinney
authors: Ms. Rue is a biostatistician, Department of Biostatistics, University of Washington, Seattle.
authors: Tessa
authors: T
authors: Rue
authors: Dr. Sathyanarayana is an assistant professor, Department of Pediatrics, University of Washington, Seattle.
authors: Sheela
authors: S
authors: Sathyanarayana
authors: Dr. Martin is a professor, Department of Oral Medicine, University of Washington, Seattle.
authors: Michael
authors: M
authors: Martin
authors: Dr. Seminario is an assistant professor, Department of Pediatric Dentistry, University of Washington, Seattle.
authors: Ana Lucia
authors: AL
authors: Seminario
authors: Dr. DeRouen is a professor emeritus, Department of Oral Health Sciences and the Center for Global Oral Health, School of Dentistry, and the Department of Biostatistics, School of Public Health, University of Washington, Seattle.
authors: Timothy
authors: T
authors: DeRouen
mesh_terms: D000293:Adolescent; D001559:Benzhydryl Compounds / Q000652:urine*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009749:Nutrition Surveys; D010636:Phenols / Q000652:urine*; D010895:Pit and Fissure Sealants / Q000737:chemistry*; D014481:United States; D055815:Young Adult; D000098826:Bisphenol A Compounds
chemical_list: D001559:Benzhydryl Compounds; D010636:Phenols; D010895:Pit and Fissure Sealants; C006780:bisphenol A; D000098826:Bisphenol A Compounds
keywords: Dental materials; National Health and Nutrition Examination Survey; bisphenol A; dental care for children; pit-and-fissure sealants; preventive dentistry; research