Research assesses the benefits of different ways of treating tooth decay in children

New research commissioned by the National Institute for Health Research Health Technology Assessment (NIHR HTA) programme will assess the benefits of different methods of managing tooth decay in children's teeth. Dental decay is one of the most common childhood diseases, with over 40 per cent of children in the UK already experiencing obvious decay in their primary (baby) teeth by five years of age, and this statistic has remained largely unchanged for the past 20 years.

Only around 12 per cent of obviously decayed baby teeth in five year olds are treated with fillings, while the vast majority are left untreated, and dental extractions remain the most common reason for children in the UK to receive an out-patient general anaesthetic.

Dr Gail Topping, Dr Nicola Innes and Dr Jan Clarkson from the University of Dundee will lead a UK-wide research team (working with others from Universities in Cardiff, Dundee, Glasgow, Leeds, London, Newcastle and Sheffield) assessing the benefits of three different methods for treating tooth decay in baby teeth with cavities. The methods studied will be: conventional fillings (numbing with local anaesthetic injections then drilling away decay before placing a filling in the cavity); biological treatment of the decay (sealing the decay into teeth with filling materials or under crowns, generally without the need to use injections or dental drills); and using only preventive techniques recommended in national guidance (better toothbrushing, less sugar in the diet, application of high fluoride varnish and fissure sealants) to stop the decay. They will also investigate what children think of the different types of treatments.

The £2.87 million study will involve children aged three to seven who already have decay in their baby teeth but have no toothache or abscesses. Participating dentists will be from general dental practices throughout the UK where children who attend for regular dental care will be invited to take part. In addition to the preventive treatment for all children in the trial, they will be randomly assigned to one of the three treatment groups. The children will be asked to rate on a special scale any discomfort they felt during each treatment and asked about what they think of the different ways of treating their teeth. All children in the trial will be seen by their dentist up to four times per year and checked for any problems which require care.

"Treatment for decay in baby teeth varies widely across the UK and there is, as yet, no conclusive evidence for the most effective approach to its management", says Dr Topping. "This trial will enable a clear recommendation to be made regarding the important question of how decayed baby teeth should best be managed in primary dental care."

To view full details about this project visit www.hta.ac.uk/1783