Insurance claim data trends in pulpal therapy for pediatric patients

Background: The purpose of this study was to identify differences in usage trends for 2 specific pulpal therapy treatments in pediatric patients during an 11-year period from January 1, 2010, through December 31, 2020.

Methods: Insurance data claims for children aged 2 through 12 years undergoing a pulpotomy or a pulpectomy performed by a general dentist (GD) or pediatric dentist (PD) from 2010 through 2020 were extracted from a dental data warehouse. The state where the provider was located was included in the extracted claim.

Results: Rates of undergoing a pulpotomy or pulpectomy declined from 2010 through 2020 (odds ratio [OR], 0.978 or 0.946, respectively; P < .001). PDs were more likely to perform pulpotomies than GDs (OR, 1.393; P < .001), but PDs were less likely to perform pulpectomies than GDs (OR, 0.225; P < .001). Younger patient age was a significant predictor for undergoing pulpotomy treatment for both GDs and PDs (ORs, 0.850 and 0.892, respectively; P < .001). With increasing patient age, PDs had increased odds of performing a pulpectomy (OR, 1.030; P < .001) and GDs had decreased odds of performing a pulpectomy (OR, 0.995; P = .04). When examining effects according to American Academy of Pediatric Dentistry national membership districts, the trends remained consistent with those above.

Conclusions: The percentage of children undergoing pulpotomy and pulpectomy therapy declined from 2010 through 2020 among both GDs and PDs.

Practical implications: These changes in pulpal therapy practice might indicate a teaching change in pulpal therapy guidelines, suggesting that less invasive pulpal therapy can be used rather than pulpotomies or pulpectomies.