Hall technique helps fight childhood caries

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Hall technique
Adjunct Professor Hanny Calache

Adjunct Professor Hanny Calache has been studying the results of the Hall Technique—a painless method for treating childhood caries—and now the first official results of his study are in, having just been presented at the International Association of Paediatric Dentistry conference in Glasgow, Scotland.

The Hall Technique is a method of treating early tooth decay in primary molars that involves no tooth cutting or preparation or local anaesthesia and is quick and inexpensive to perform. It was developed in Scotland, where there are high rates of untreated dental caries in primary teeth, and was subject to a five-year clinical trial in the UK.

A research team led by Dental Health Services Victoria’s pediatric dentist, Adjunct Professor Hanny Calache, is conducting a study using stainless steel caps/crowns to seal decay in young children’s baby molars without using a needle or a drill.

“Sealing early to moderate levels of tooth decay stops it from getting worse. The majority of children in this study did not experience any discomfort during the procedure, which takes about 5 minutes to complete. It is a fantastic and exciting innovation that could dramatically reduce the need for drilling and filling young children’s baby teeth,” said Prof Calache.

Dental health ranks particularly highly in Ambulatory Care Sensitive Condition admissions data—that is, the markers of hospital admissions that could have been avoided through more effective primary care. Such unnecessary admissions are currently estimated to cost $9 million annually in Victoria alone.

The challenge for clinicians and healthcare workers is to develop a way of treating the condition that is more effective than current education and preventative strategies, and finding ways to do so that will appeal to children and their carers. With the Hall Technique, the practitioner does not cut away any of the decayed tissue. Instead, the molar is sealed under a stainless-steel crown, which isolates it from the surrounding healthy teeth and prevents further decay by starving bacteria of oxygen. Because you’re not removing the tooth, there’s no need for anaesthetic.

“Stainless steel crowns have been in use for more than 60 years but this is the first time in Australia they have been investigated to seal tooth decay in children’s teeth,” said Professor Calache.

Finding a way to tackle childhood caries effectively is vitally important in Australia. Our rates of hospitalisation for childhood tooth decay are high, particularly in disadvantaged, Indigenous and rural and remote communities—in fact, dental decay is one of the most common chronic diseases for children under the age of six. Childhood caries also has implications for development and health, including pain, abscesses and infection which in turn can cause reduced general health and poor sleep. In the longer term, it is thought that children can develop social and even academic problems from the stigma and discomfort of poor dental health.

The Phase 1 results of Professor Calache’s study have been released for the first time this week. The study included 251 children (aged 3 to 7 years), and demonstrate that the Hall Technique:

  • has the real potential to reduce stress  and anxiety for children and  their families around dental treatment
  • has the potential to reduce referrals for general anaesthesia for the management of dental decay in young children

The research is now entering Phase 2 of the trial which will test the success of the technique at 6, 12 and 24 months after being placed on the baby molars of this group of Australian Children.

The study is funded by the William Buckland Foundation and is undertaken in partnership with North Richmond Community Health, Monash Health and Barwon Health, Melbourne Dental School, University of Adelaide, Deakin University and the Australian Dental Council.

 

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