Study shows fillings may not be best treatment for childhood dental caries

Dental Tribune International

Fri. 6 December 2019

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LEEDS, UK: Though dental fillings are an established method of treating the presence of dental caries in permanent dentition, their usefulness for treating caries in primary dentition remains under debate. A new study has cast further doubt on the appropriateness of this approach, suggesting that there is no evidence that conventional fillings are more effective in stopping further caries and/or pain in children than other treatment modalities are.

The study analysed the results of the FiCTION (Filling Children’s Teeth: Indicated or Not) trial, which involved 1,144 UK-residing children between 3 and 8 years old who suffered from caries. Each participant was randomly assigned one of three treatment options for the duration of the trial (which lasted up to three years for some children): the standard “drill and fill” approach, which involves drilling out the decayed tissue; a minimally invasive approach of sealing the caries under a metal crown or filling; and the avoidance of any fillings being placed while also emphasising a reduction in sugar intake and the necessity of taking greater care of the child’s oral health.

A total of 450 participants reported that they continued to experience further caries and pain. There were no significant differences between the outcomes for each of the three treatment groups.

“Our study shows that each way of treating decay worked to a similar level but that children who get tooth decay at a young age have a high chance of experiencing toothache and abscesses regardless of the way the dentist manages the decay,” said Prof. Nicola Innes, chair of paediatric dentistry at the University of Dundee School of Dentistry and lead author of the study.

“What is absolutely clear from our trial is that the best way to manage tooth decay is not by drilling it out or sealing it in—it’s by preventing it in the first place,” Innes added.

The study, titled “Child caries management: A randomized controlled trial in dental practice”, was published online on 26 November 2019 in the Journal of Dental Research, ahead of inclusion in an issue.

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