DentaltownUK May 2017 - 28

golden nuggets

Golden Nuggets
Top Tips for The Hall Technique

with Eileen
Johnston
Eileen Johnston BSc (Hons),
BDS, MFDS RCSEd qualified
from Glasgow University
dental school in 2004 and
has worked within general
practice and the Public
Dental Service (PDS) in both
the Lothian and Greater
Glasgow areas. She is
currently working as a PDS
Dental Officer within the
paediatric service of Greater
Glasgow and Clyde. She has
special interests in
paediatric dentistry and
anxiety management. She
has completed her training
in cognitive behavioural
techniques for treatment of
dental fear at Kings College
London and the Medical and
Dental hypnotherapy
training with BSMDH
Scotland.

28

MAY 2017 // dentaltownuk.com

Preformed metal crowns
for the primary molar-
challenge yourself!

I

remember as a young newly qualified dentist
always checking my day list in practice and
having that heart-sinking moment when I
realised I was treating a young child with caries
in his or her primary dentition.
How do you prepare yourself for the potential
onslaught of anxieties, tears and every other emotion a young child can throw at you when faced
with a dental visit, coupled with the parents'
fears and your own questioning conscience of
how you're going to restore that carious primary
molar to the best of your ability? All of this whilst
providing the child with a good experience and
a one-off, predictable and durable restoration
to allow natural exfoliation at the correct time!
When I was an undergraduate we were taught
conventional restorative techniques using local
anaesthetic, caries removal and restoration with
amalgam, composite (if you were skilled enough
to achieve isolation in a wriggling 5-year-old
with limited access), and the conventional
preformed metal crown (PMC) preparation.
These restorations absolutely have their
successes-especially in the ideal cooperative
child-but unfortunately a significant proportion of young children do not have that level of
cooperation. Many have anxieties over the use
of local anaesthetic, drills or suction, and so it
was with the advent of the 'Hall Technique' that
my own anxieties began to diminish. I could
now see a way to treat a child, anxious or not.
Utilising this simplistic yet skilled, noninvasive
technique, I could achieve a predictable, durable
result and have a happy child at the end of

the visit.
The 'Hall Technique' was named after a
general dental practitioner (GDP) Dr Norma
Hall from Scotland, who simplified restoring a
carious lesion on a primary molar by cementing
a PMC without prior use of local anaesthesia,
caries removal or tooth preparation.1 The
Hall Technique is described as a biological
restoration-one that works by denying the
bacteria in the carious cavity nutrients from
the oral environment by sealing them into
the tooth. This eliminates the ability of the
carious lesion to progress toward the pulp.2,3
Randomised controlled trials have found the
Hall Technique as good as or better than
comparable treatments with success rates of
97% over 5 years.4
As Evans and Innes state in their user manual,5
the Hall Technique is a useful and effective tool
to have in our armamentarium for management of a carious primary molar. However,
it is still underutilised in general practice
despite being time-efficient and providing a
greater remuneration in comparison to other
conventional primary restorations.
To establish which carious primary molars are
suitable for this technique, a full history, clinical
examination and appropriate investigations
including radiography (ideally bitewings) should
be performed. Table 1 outlines the indications
and contraindications for suitable case selection
for the Hall Technique. Medically compromised
children who are immunosuppressed or at risk
of bacterial endocarditis should be referred for
http://www.dentaltownuk.com
Table of Contents for the Digital Edition of DentaltownUK May 2017
