STOMATOLOGY EDU JOURNAL 2017, Volume 4, Issue 3 SEJ_3-2017_Online - Page 66

THE HALL TECHNIQUE IN PAEDIATRIC DENTISTRY: A REVIEW OF THE LITERATURE AND AN “ALL HALL” CASE REPORT WITH A-24 MONTH FOLLOW UP and this contributed to the self-correction of the high bite. It was based on a study that looked at recording the bite, pre/immediate post op/ and six weeks following SSC placement in 10 child patients. The measurements were carried out using photos, clinical measurements, models and laser 3D scanning. The bite had returned to normal levels after 2 weeks. 15 Recently, in December 2014, a landmark article was published in the USA supporting the use of the HT in dental practice. 23 It was a retrospective clinical study, where the authors found that 97% of SSCs placed with the HT and 94 % of SSCs placed with the traditional technique were successful. This study confirmed that the HT was similar in its successful outcomes to those SSCs placed conventionally. This interesting debate within the paediatric dental circle is still ongoing even as this article is being written, and the debate is often as emotional as it is scientific. However, HT is now becoming more mainstream; it is now taught formally in the undergraduate curricula in 15 out of 16 dental schools in the UK 30 and more than half of European paediatric dentistry postgraduates will consider using this technique in managing child patients 31 and the HT has recently celebrated its 10 th “formal” anniversary. 32 Despite it being very popular in parts of the world such as the UK and New Zealand, there is still reluctance to practice it in the UAE and the Gulf Cooperation Council Region as a whole. 33 7. Conclusion Dental caries is a childhood epidemic disease. While prevention is of essence, in a society where dental caries is rampant, its treatment can be challenging especially in young children. The HT for restoring the carious primary molar is a newly developed technique that is based on an old concept: deprive caries from sugar substrate and it will arrest. The carious lesion needs to be detected early enough References 1. 2. 3. 4. 5. 6. 7. 8. 216 World Health Organization. [Internet: available http://www. Last accessed 8th April 2017] El-Nadeef MA, Hassab H, Al-Ho sani E. National survey of the oral health of 5-year-old children in the United Arab Emirates. East Mediterr Health J. 2010;16(1):51-55. [PubMed] Hussein SA, Doumit M, Doughan B, El-Nadeef M. Oral health in Lebanon: a pilot pathfinder study. East Mediterr Health J. 1996;2(2):299-303. Wendt LK, Hallonsten AL, Koch G. Oral health in pre-school children living in Sweden. Part III--A longitudinal study. Risk analyses based on caries prevalence at 3 years of age and immigrant status. Swed Dent J. 1999; 23(1):17-25. [PubMed] Hugoson A, Koch G, Helkimo AN, Lundin SA. Caries prevalence and distribution in individuals aged 3–20 years in Jonkoping, Sweden, over a 30-year period (1973–2003). Int J Paed Dent. 2008;18 (1):18–26. doi: 10.1111/j.1365-263X.2007.00874.x [Full text links] [PubMed] Oral health survey of three-year-old children 2013. A report on the prevalence and severity of dental decay. Public Health England. [Internet: available dentalhealth/reports/DPHEP%20for%20England%20OH%20 Survey%203yr%202013%20Report.pdf.Last accessed 8th April 2017] Kidd E. Should deciduous teeth be restored? Reflections of a cariologist. Dent Update. 2012;39(3):159–162, 165-166. [PubMed] Scottish Dental Clinical Effectiveness Programme. Prevention and Management of Dental Caries in Children Dental Clinical Guidance. [Internet: available content/uploads/2013/03/SDCEP_PM_Dental_Caries_Full_ Guidance1.pdf. Last accessed 8th April 2017] before it causes pulpal symptoms, emphasizing on the importance of early diagnosis using clinical examinations coupled with bitewings radiographs. This will enable the lesion to be caught at a very early stage, for it to be sealed in using a SSC utilising the HT. The crown could be fitted with minimal inconvenience to the child patient in a child friendly way. This will negate the need for LA injection, rubber dam, drilling the caries out. While the conventional restorative approach is part and parcel of the skills of a specialist in paediatric dentistry, the HT must become part of the armamentarium in the fight against dental decay; a “tool” in the dentists “toolbox”. One of the HT unique features is that it can be used in general dental practice by GDPs, where most children are treated; therefore, the HT is a suitable modality for the GDP environment. The HT manual showing the technique step by step is available online to be downloaded for free for those dentists who would like to use it in their practice. 9 The case reported here is an “All Hall” case where the maximum capacity of the HT was used in one single child. Although well designed trials are in place to support the HT, this case highlights that restoring eight carious primary molars in one child, with no short to medium term complications, is achievable using the HT. The lesions need to be “caught” prior to any pulpal involvement. It may be of interest to GDPs and primary care dentists, in addition to specialists in paediatric dentistry, who deal with the majority of child dental patients. Author Contributions Equal contribution to the paper. Acknowledgement There are no conflicts of interest and no financial interests to be disclosed. The author would like to thank the patients and carers who consented to the use of the photos shown in this article. 9. 10. 11. 12. 13. 14. 15. 16. Evans D, Innes N, Stewart M, Keightley A. The Hall Technique. A Minimum intervention, child centred approach in managing the carious primary molar. A user manual. Version 4, 2015. [Internet: available V4.pdf. Last accessed 8th April 2017] Innes NP, Evans DJP, Stirrups DR. 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;7:18. doi: 10.1186/1472-6831-7-18. [Full text links] [Free PMC Article] [PubMed] Innes N, Evans D, Hall N. The Hall Technique for managing carious primary molars. Dent Update. 2009;36(8):472-474, 477-478. [PubMed] Rodd HD, Waterhouse PJ, Fuks AB, et al. Pulp therapy for primary molars. Int J Paediatr Dent. 2006;16 Suppl 1:15–23. doi: 10.1111/j.1365-263X.2006.00774.x [Full text links] [PubMed] Kindelan SA, Day P, Nichol P, et al. UK National Clinical Guidelines in Paediatric Dentistry: stainless steel preformed crowns for primary molars. Int J Paediatr Dent. 2008;18 Suppl 1:20-28. doi: 10.1111/j.1365-263X.2008.00935.x. [Full text links] [PubMed] van der Zee V, van Amerongen WE. Short communication: Influence of preformed metal crowns (Hall technique) on the occlusal vertical dimension in the primary dentition. Eur Arch Paediatr Dent. 2010;11(5):225-227. [PubMed] So D, Evans D, Borrie F, et al. Measurement of occlusal equilibration following Hall crown placement: pilot study. [Presentation] International Association of Dental Research (IADR). Boston, USA, 2015. J Dent Res. 2015;94:A. Ghaith B, Hussein I. The “All Hall” case: a case report of maximum capacity use of the hall technique in a single child Stoma Edu J. 2017;4(3): 208-217