Acceptability and feasibility of minimally invasive restorative procedures for patients with disability. A cohort study.

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Unmet caries treatment needs are prevalent among peoplewith disability, partly due to difficulties of cooperation during conventionaldental treatment. This cohortstudy compared atraumatic restorativetreatment (ART), silver modified atraumatic restorative treatment (SMART), and conventional restorative treatment (CRT),in terms of feasibility andacceptability in patients referred forspecial care dentistry in a specialized university clinic. Patients referred for dental restorative carewere treated using either ART, SMART, or CRT approach. Acceptance,feasibility, and complexity for the provision of care according to the BDA Case Mix Tool wereassessed. ANOVA with Bonferroni correction and Chi-square testsinvestigated differences in age, gender, and BDA scores. Spearman Logistic Regression was used to correlate treatment selection with BDA scores. From a total of 150 patients, 74 were included (20.6±11.2 years of age) 26 chose ART, 35 SMART, 11 CRT and 2 were referred for sedation/GA. ART, SMART, and CRTwere feasible forall patients who had selected these options, with optimal placement of restorations for all patientsreceiving ART, 95.8% of patients receiving SMART, and all patients receiving CRT.Local anesthesia wasrequired for4of the 26patients receiving ART and for the 11 patients receiving CRT, but not required for any of thepatients receiving SMART (p=.001). BDA-complexity scores were significantly higher for patients receiving SMART (OR 3.730, 95% CI 0.0∼1.82, p ≤.001). ART and SMART are feasible and acceptableapproaches to restorative dental treatment in patients witha disability who have difficulty coping with conventional treatment.CRT is more likely to be selected by patients with lower BDA-scores. The survival of the restorations should be assessed to determine the effectiveness of these options and further research is required to confirm the results of this pilot study in a larger population.