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Oral Health

Investigating the use of a stainless steel crown to cover decayed primary molar teeth in children to improve dental hygiene

Dr Lyndie Foster Page
University of Otago, Dunedin

What is the problem and who does it affect?

Dental decay (caries) is the most common chronic childhood disease and over 50% of New Zealand five year olds have dental caries. This affects children’s eating, sleeping, school performance and behaviour, as well as impacting on general health.

Conventional dental treatment with drilling and injections is invasive and considerable amounts of the healthy part of the tooth are lost in the process. The treatment is also expensive and inefficient, as it often requires repeat treatments. In New Zealand, almost 5,000 children are treated under general anaesthesia every year for dental decay.

The ‘transformer tooth’ is a novel approach to dental treatment in which the Hall Technique is used in dental decay management. This involves placing a stainless steel crown (SSC) or ‘cap’ over decayed primary teeth in children.

The aim of this trial is to determine whether using the Hall Technique in primary care leads to improvements in child oral health. If successful this study may pave the way to a paradigm shift from the traditional ‘drill and fill’ management techniques, not only for children but also for adults.

What is this research hoping to achieve?

This randomised control trial has three important features: (1) a stainless steel crown (SSC) is cemented and requires no tooth drilling and no local anaesthetic injections; (2) decayed tooth tissue is not removed, but is sealed off from the mouth, stopping or slowing the progression of decay; and (3) SSCs are highly durable with minimal repeat treatment necessary.

The study will determine whether adopting this technique in primary care leads to improvements in child oral health and enhanced productivity in primary oral health care. It’s anticipated that children will experience fewer repeat dental interventions, reduced need for general anaesthesia, and will retain their teeth.

Treated teeth will be recovered for laboratory analysis after the child spontaneously loses them. The data gained will provide a better understanding of the science behind the technique’s clinical effectiveness.