Atraumatic Restorative Treatment (ART) in Pediatric Dentistry Residency Programs: A Survey of Program Directors

Purpose: The purpose of this study was to investigate the extent of clinical training on atraumatic restorative treatment (ART) among pediatric dentistry residency programs and assess program directors' attitudes toward ART. Methods: All U.S. Pediatric Dentistry residency programs' directors were asked to complete a web-based survey. Sixty-one of the 76 directors (80 percent) completed the survey, with no significant response bias. Results: Eighty-nine percent of the responding programs provided clinical instruction on ART. Of these, 30 percent provided ART training often/very often. ART was used mostly in single-surface cavities (43 percent) and as an interim treatment in primary teeth (57 percent). Factors associated with ART clinical training included not placing amalgams in primary teeth (P<.03) and having directors with positive attitudes toward ART (P<.001). Factors associated with directors' positive attitudes included believing that child's caries risk (P<.006), professional guidelines (P<.003), and patient insurance status (P<.04) were all important in selecting restorative treatment. Conclusions: Atraumatic restorative therapy appears to be underused in pediatric dentistry residency programs in the United States. Residency directors' attitudes were highly predictive of the amount of clinical training provided, suggesting that directors need to be better informed about the use of ART.