Non-conventional caries management techniques for children show promise

Secondary care-based, three-arm parallel-group, randomised controlled trial.

Children aged three to eight years old with at least one primary molar tooth with caries into dentine involving two dental surfaces were randomised to either; conventional restoration (CR) with local anaesthesia, Hall technique (HT) or non-restorative caries treatment (NRCT) with no local anaesthetic. Only one tooth per child was included and parents were present during treatment.

Child's pain perception (Visual Analogue Scale of Faces); behaviour (Frankl scale); and parents' and dentists' treatment opinions (five-point Likert scales).

One hundred and sixty-nine children (96 boys and 73 girls) were randomised; 52 received HT; 52 NRCT and 65 CR. Children showed more negative behaviour in the CR group (37%) compared to NRCT (21%) and HT (13%) (P = 0.047, CI = 0.41 to 0.52). Pain intensity was rated 'very low' or 'low' in 88% NRCT, 81% HT, and 72% CR (P = 0.11, CI = 0.10 to 0.12). NRCT and HT were 'very easy' or 'easy' to perform for >77% of dentists, compared to 50% in CR group (P < 0.000). There were no statistically significant differences in parents' rating of their child's level of comfort (P = 0.46, CI = 0.45 to 0.48).

Dentists reported more negative behaviour in the CR group. For all techniques, children's pain perception and dentist/parent acceptability were similar.