The Hall Technique – managing carious molars in children
Featured Products Promotional FeaturesPosted by: Dental Design 2nd January 2022
Statistics surrounding childhood tooth decay are more than concerning. Before the outbreak of the pandemic, figures released by Public Health England suggested that almost 25% of five-year olds in the UK had dental decay.[i] During the pandemic, a number of barriers to care were put in place that are likely to have aggravated the situation further.
News reports have revealed that the number of children who attended dental appointments fell by 50% during the first year of the pandemic,[ii] meaning that in total two thirds of the UK child population (those aged under 16) did not see an NHS dentist at all in 2020.[iii] Though there are currently no concrete figures available on what this has done to levels of childhood tooth decay, it’s safe to say that the number of children suffering is likely to have increased, especially when we factor in other impacts of the pandemic such as many children eating more junk food during this time.[iv]
Prevention, as ever, is key, but with more children presenting with caries, it’s a smart idea for professionals to be acquainted with every available option to help treat these cases.
Challenges of treating children
Paediatric dentistry comes with a number of hurdles that need to be overcome in order to provide the best treatment possible. Carious teeth are particularly problematic, as heavy restoration of these would traditionally involve invasive removal of decayed material and administration of anaesthetic.
But what if there were a way to reliably overcome these barriers?
Introducing the Hall Technique
Preformed Metal Crowns (PMC), though used in paediatric dentistry since the 1950s, are not widely utilised in primary care at this time despite being a viable option. This is generally because placement of these restorations involves the need for anaesthetic, extensive removal of decayed tooth matter and the potential to damage the adjacent teeth during placement, all of which could have a long-lasting impact on the child’s oral health moving forward. As such, PMCs make up only 1% of restorations currently provided for children.[v]
One way to navigate these pitfalls is through use of the Hall Technique – a non-invasive, proven method that has been specifically developed to treat carious primary molars in children. A conservative treatment choice, the Hall Technique involves the placement of a preformed metal crown over the affected tooth without general anaesthesia, caries removal or tooth preparation of any kind.[vi]
A question of caries
The vast majority of dental treatment advocates the removal of caries-affected tooth structure. However, what many treatment modalities don’t consider is the unique nature of caries and plaque and how different environments can impact caries progression. Studies examining the Hall Technique have concluded that it is an effective treatment choice as it essentially seals caries within the tooth, preventing them from receiving the outside influences such as saliva, sugar and other catalysts that would further their development.[vii]
What are the risks?
Like all treatment methods, the Hall Technique requires careful case selection. The risks of this method are similar in nature to those incurred by conventional restoration techniques, and may include pain, major failures such as pulpitis and abscess and minor failures such as reversible pulpitis, lost crown and secondary caries formation.
Interestingly, a study that assessed 132 children, some of whom received the Hall Technique and others who received conventional restorations, provided some solid data suggesting that the former was a more effective treatment choice. In this sample, 11 children who received conventional treatment were left with pain, compared with only 1 who received the Hall Technique. Similarly, Major failures (15 with conventional treatment, 2 with the Hall Technique) and minor failures (50 with conventional treatment, 5 with the Hall Technique) were much lower in those who received this alternative treatment.[viii]
In light of this, it’s clear that the Hall Technique is a viable treatment choice in paediatric dentistry. Training in this technique is, of course, essential, but you need to also ensure that you have the right products to help support the delivery of reliable outcomes.
3M Stainless Steel Crowns for Primary Molars have been especially created for convenient care. Pre-trimmed, belled and crimped for fast and easy placement, they also accurately echo the anatomy of natural primary molars for better fit and performance.*
Natalie Bradley, A Specialist Registrar in Special Care Dentistry who hosts sessions focusing on the Hall Technique comments:
“3M Stainless Steel Crowns for Primary Molars are the gold standard in managing caries in the primary dentition. They are evidence based to have better clinical results than conventional filling materials in children when used in the Hall Technique and parents and children prefer them! Using them in the Hall Technique is a simple and effective way for general practitioners, not just specialists, to achieve the best clinical outcomes.”
Keep your options open
With childhood tooth decay levels remaining high, it’s important to have a repertoire of skills to help treat this growing problem. The Hall Technique is just one solution, but it is a proven, effective method that could make all the difference for this vulnerable patient group.
*3M Internal Data
For more information, call 0845 873 4066 or visit www.3m.co.uk/Dental
3M is a trademark of the 3M Company.
[i] Oral Health Foundation. New Statistics On Childhood Tooth Decay Suggest Concerning Lack Of Progress. Link: https://www.dentalhealth.org/news/campaigners-look-to-address-childhood-tooth-decay-issue-2020 [Last accessed October 21].
[ii] The Telegraph. Millions Of Children Could Face a Lifetime Of Rotten Teeth In The Wake Of The Pandemic. Link: https://www.telegraph.co.uk/news/2021/08/15/millions-children-could-face-lifetime-rotten-teeth-wake-pandemic/ [Last accessed October 21].
[iii] Royal College of Surgeons England. Two Thirds of Children Did Not See an NHS Dentist Last Year. Link: https://www.rcseng.ac.uk/news-and-events/media-centre/press-releases/children-dental-attendance-2020/ [Last accessed October 21].
[iv] CNN Health. 1 in 5 Parents Say Their Kids Eat More Fast Food During The Pandemic, Poll Finds. Link: https://edition.cnn.com/2021/09/20/health/fast-food-consumption-children-pandemic-poll-wellness/index.html [Last accessed October 21].
[v] NHS. The Hall Technique – A Child Centred Approach To Managing The Carious Primary Molar. Link: https://heeoe.hee.nhs.uk/sites/default/files/1311845532_nqvh_the_hall_technique_manual.pdf [Last accessed October 21].
[vi] NHS. The Hall Technique – A Child Centred Approach To Managing The Carious Primary Molar. Link: https://heeoe.hee.nhs.uk/sites/default/files/1311845532_nqvh_the_hall_technique_manual.pdf [Last accessed October 21].
[vii] NHS. The Hall Technique – A Child Centred Approach To Managing The Carious Primary Molar. Link: https://heeoe.hee.nhs.uk/sites/default/files/1311845532_nqvh_the_hall_technique_manual.pdf [Last accessed October 21].
[viii] NHS. The Hall Technique – A Child Centred Approach To Managing The Carious Primary Molar. Link: https://heeoe.hee.nhs.uk/sites/default/files/1311845532_nqvh_the_hall_technique_manual.pdf [Last accessed October 21].
