How long do direct restorations placed within the general dental services in England and Wales survive?

Aim It is the aim of this paper to consider the factors associated with the need for re-intervention on direct-placement restorations placed within the general dental services of England and Wales. Methods A large age-stratified sample of adult patients and their dental intervention were tracked over 11 years to December 2001. For each tooth treated with a direct restoration the subsequent history of intervention on that tooth was consulted, and the next date of intervention, if any could be found in the extended data set, was obtained. The distribution of times to re-intervention for different types of restoration in different circumstances was obtained using Kaplan-Meier survival analysis. Results Data for over 80,000 different adult patients were analysed, of whom 46% were male and 54% female. A total of 503,965 restoration placements were obtained from the data over a period of 11 years. Single surface amalgam restorations were found to have the longest survival - 58% at ten years, and glass ionomer the shortest - at 38% at ten years. Conclusions Small amalgam restorations have longer survival times before re-intervention than large amalgam restorations such as MOD. Composite and glass ionomer restorations perform less well than amalgam restorations. Restorations placed by older dentists and restorations placed in older patients have shorter time to re-intervention. Patients who changed dentist were found to have restorations which performed less well than those placed in patients who did not change dentist.