notice in our study that, although not statistically
significant, there was a tendency for PDs to avoid
the use of CH [CH causes internal resorption 19,17 ]
and chose either FS or FC equally (thus adhering
either to the AAPD or the BSPD school of thought).
Despite this, background training of those
surveyed showed no clear relationship with the
PM choice. Finally small proportions of GDPs and
PDs (13.4% and 16.1% respectively) chose MTA as
a PM medicament. No reason can be extrapolated,
however as mentioned above MTA is known to be
a costly material.
4.3. Discussion of the Hall technique (HT)
The HT 6,10 is a method in which an asymptomatic,
non- pulpally involved and aseptic carious primary
molar lesion is managed unconventionally. The
lesion is “biologically” treated by isolating it from
the oral cavity; by cementing a conventional
SSC on the tooth with glass ionomer cement
in a child friendly play manner. 27 There is no LA,
drill nor is there any tooth cutting carried out 6 .
The first appointment involves fitting orthodontic
separators mesially and distally to the tooth
intended for restoration with the HT. The second
appointment involves removal of separators 3-5
days after the first appointment and selection and
cementation of the SSC with GIC by digital and
patient bite pressure. 10
There was a mixed international reaction to the
development to the HT in paediatric dentistry
circles 28 with many authors supporting it 29,30 and
others condemning it outright. 8 In the UK, some
had gone so far as to describe it as the “Gold
Standard” for restoring the multi-surface carious
molar. 9 Our study investigated the knowledge
and practice of the HT. It showed that a majority
of those surveyed had heard of (n=91, 60.6%)
but not practiced (n=122, 81.4%) the HT. The
speciality had a significant impact on this as PDs
were more aware of, and had practiced the HT
more, when compared to GDPs (p=0.003 and
p=0.003 respectively). This can be understood as
the HT trials were designed and spearheaded in
postgraduate paediatric dentistry environments 29
and developments disseminated in specialists
postgraduate conferences, attended mostly by
PDs. 1 However, some of the said studies were
conducted in the primary dental service setting,
i.e., GDPs. 6 Ideally; the ultimate aim of developing
the HT was for GDPs becoming the end users
of the HT in order to share the burden of caries
management between GDPs and PDs. This was
because most children are seen by GDPs not PDs.
It appeared that our study had shown that there is a
large gap between knowledge and practice of the
HT in this region. One can also apply conjecture
and assume that other confounding factors, such
as opposition to the HT may also play a part
in avoidance of practice, in addition to lack of
appropriate hands on courses to cover the subject.
However, the latter points were not investigated
in this study and warrant further investigation.
Finally, it may be useful to recall the responses
highlighted in section a) of this paper’s discussion
(RCM), as less than a quarter of the respondents
only, would choose the HT as a treatment modality,
in the given straight forward scenario.
4.4. Discussion of sealing dental caries (SDC)
The therapeutic treatment of carious lesions
in primary and permanent teeth by complete
removal of caries and restoring the defective
tooth structure had classically been advocated
as the only treatment modality for many years.
When taking primary teeth into account, this was
confirmed to be the case by those surveyed in the
first question in our study. On the other hand, the
thought of SDC, especially in a permanent tooth,
may be considered malpractice by many; however,
it is now becoming acceptable that the therapeutic
treatment of carious lesions by complete removal
CONTEMPORARY DENTAL CARIES MANAGEMENT CONCEPTS IN PAEDIATRIC DENTISTRY:
A SURVEY OF AWARENESS AND PRACTICE OF A GROUP OF GULF COOPERATION COUNCIL DENTISTS
Figure 9. Sealing-in caries and specialty (GDP or PD). No statistically significant results were found between GDPs
and PDs.
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