Dental Composite Material May Affect Children's Behavior

Dental Composite Material May Affect Children’s Behavior

The effects of resin-based composite material on children’s psychosocial health were investigated in a study published in the July issue of Pediatrics. Resin-based restorative materials can emit chemicals, including bisphenol A (BPA), into the oral cavity, and investigators wanted to see if increased exposure to these chemicals heightened the likelihood of anxiety, depression, stress, or interpersonal relationship difficulties among children.

Researchers at the New England Research Institute in Watertown, Mass, used data from an earlier study, the New England Children’s Amalgam Trial (NECAT), which was designed to investigate the safety of amalgam restorations due to concerns about mercury exposure. The initial study included 534 subjects ages 6 to 10 and was conducted over 5 years. The NECAT study found no adverse effects among the children who received the amalgam restorations—however, the researchers did note that the children with amalgam restorations did better on the psychosocial outcome assessments than those who had received composite restorations.

The new study delved more deeply into the psychosocial outcomes of the two participating groups at their 5-year follow-up. One group had received bisphenol A-glycidyl methacrylate (bisGMA)-based composite or urethane dimethacrylate-based polyacid-modified composite (compomer), while the other received only amalgam-based restorations. At the 5-year follow-up, 434 of the study participants had been evaluated using two psychosocial evaluation tests: the self-reported behavior assessment system, and the parent-reported child behavior checklist.

Children with increased exposure to the bisGMA-based composite had lower follow-up scores on the emotional symptoms, clinical maladjustment, and personal adjustment parts of the behavior assessment system. This relationship was more pronounced among children who had bisGMA-based composites on the posterior-occlusal surfaces, which are the most likely to degrade. By comparison, no negative psychosocial effects were seen in the children exposed to compomer or amalgam restorations.

The psychosocial effects demonstrated by this study are small, and confounding factors were not controlled, thus, the authors do not purport that the results warrant a change in current restorative-care practices. Rather, they suggest that more research is necessary to understand possible associations. The results do emphasize, however, the importance of caries prevention, which eliminates the need for restorative care.