20 December 2007

Simple push filling wins crown in battle against tooth decay

Embargoed until: 20 December 2007, 00.01 GMT

A simple technique using a preformed crown offers an improved and effective method to fight tooth decay in children’s molars

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, reveals research published in the online open access journal BMC Oral Health. 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."

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Notes to Editors

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.

Dentists ranked the degree of discomfort their patients experienced, and the children, their parents/carers and dentists stated if they preferred the Hall Technique or traditional methods of treatment.

A copy of the Hall Technique instruction manual can be found at: www.scottishdental.org/resources/HallTechnique.htm

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 (in press)

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5. BMC Oral Health is an open access journal publishing original peer-reviewed research articles in all aspects of the prevention, diagnosis and management of disorders of the mouth, teeth and gums, as well as related molecular genetics, pathophysiology, and epidemiology. BMC Oral Health (ISSN 1472-6831) is indexed/tracked/covered by PubMed, CAS, Scopus, EMBASE, and Google Scholar.

6. BioMed Central (www.biomedcentral) is an independent online publishing house committed to providing immediate access without charge to the peer-reviewed biological and medical research it publishes. This commitment is based on the view that open access to research is essential to the rapid and efficient communication of science.

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