The Hall Technique, which uses preformed metal crowns pushed onto teeth with no dental injections or drilling, is favoured over traditional "drill and fill" methods by the majority of children who received it. Tooth decay can be slowed, or even stopped, when it is sealed into the tooth by the crown.
Dr Nicola Innes, who led the Scottish research team at Dundee Dental Hospital and School, explained, "There has been a lot of debate in the UK over the best method to tackle tooth decay in children's molars. Preformed metal crowns are not widely used in Scotland as they're not viewed as a realistic option by dentists. We found, however, that almost all the patients, parents and dentists in our study preferred the Hall Technique crowns and also children benefited from them."
Traditionally, dentists "freeze" a decayed tooth with an injection in the child's gum, and then drill away the decay, and fill the cavity with a metal filling. This method can be uncomfortable for the child. The Hall Technique, however, is simple. The decay is sealed into the tooth by the crown and, as sugars in the diet are unable to reach it, the decay slows or even stops. 132 children in Tayside, Scotland, had one decayed tooth filled traditionally, and another decayed tooth managed with the Hall Technique. 77% of the children, 83% of carers and 81% of dentists preferred the Hall Technique to traditional "drill and fill" methods. Dentists reported that 89% of the children showed no significant signs of discomfort with the Hall Technique, compared with 78% for the traditional fillings.
Around one in two children in Scotland has visible tooth decay at the age of 5. Most children have to accept toothache as part of normal everyday life. Two years after receiving the Hall Technique crown, however, the children's dental health significantly improved, with less pain, abscesses and failed fillings than with the traditional "drill and fill" methods.
Dr Innes concluded "Children, parents and dentists prefer the Hall Technique. It allows dentists to achieve a filling with a high quality seal, which means we can safely leave decay in baby teeth, and not be forced to drill it away. Hall crowns will not suit every child, or every decayed tooth in a child's mouth, but dentists may find it a useful treatment option for managing decay in children's back teeth."
The Hall Technique uses preformed metal crowns (PMCs) filled with glass ionomer cement which are simply pushed onto the tooth with no caries removal as;
- PMC is cemented into place without tooth preparation or local anaesthetic injection
- Decayed dental tissue is not removed but sealed into tooth by PMC cement and so isolated from sugars in the diet.
- Innes et al. The Hall Technique; a randomized controlled clinical trial of a novel method of managing carious primary molars in general dental practice: acceptability of the technique and outcomes at 23 months. BMC Oral Health, 2007; 7 (1): 18 DOI: 10.1186/1472-6831-7-18
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