Fillings not the best way to tackle tooth decay in children

tooth decay

There’s no evidence to suggest conventional fillings are more successful than sealing decay into teeth.

Findings from a major dental trial suggest that preventing tooth decay from occurring in the first place is the most effective way for parents to help avoid pain and infection from decay in their children’s teeth.

Dentists from the Universities of Dundee, Newcastle, Sheffield, Cardiff, Queen Mary University of London and Leeds led a three-year study .

It compared three different treatment options for tooth decay in children’s teeth.

They found no evidence to suggest that conventional fillings are more effective than sealing decay into teeth or using prevention techniques alone, in stopping pain and infection from tooth decay in primary teeth.

The Fiction trial

The Fiction trial, also found that 450 children who took part in the study experienced tooth decay and pain.

This was regardless of which kind of dental treatment they received.

Professor Nicola Innes, from the University of Dundee and lead author explains.

‘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.

‘What is 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.’

More than 1,140 children between the ages of three and seven with tooth decay were recruited by dentists throughout the country.

One of three treatment approaches was then chosen randomly for each child’s dental care for the three year duration of the trial.

Different approaches

The first approach avoided placing any fillings and aimed to prevent new decay by reducing sugar intake.

It ensured twice-daily brushing, application of fluoride varnish and placing of fissure sealants on the first permanent molars.

The second option involved drilling out tooth decay.

This is based upon the standard ‘drill and fill’ practice, together with preventive treatments.

The third treatment strategy was a minimally invasive approach.

Tooth decay was sealed in under a metal crown or a filling to stop it progressing together with preventive treatments.

There was no evidence to suggest that any of the treatment strategies were better than another.

All three different ways of treating decay were acceptable to children, parents and dental professionals.

The best way of managing children’s decay was sealing-in with preventive treatment.

This is if society would be willing to pay a minimum of £130 to avoid an episode of pain or infection.

Prevention before decay begins

Professor Anne Maguire from Newcastle University explains.

‘The Fiction findings have focused attention again on the need to prevent dental decay before it begins.’

There are a number of treatment options available tailored to the needs of an individual child, she added.

Scotland’s chief dental officer, Tom Ferris, said, ‘Fiction highlights the importance of preventing tooth decay in our youngest children.

‘I believe the key to success in prevention lies within families and communities’

‘For this reason Scottish Government launched the Oral Health Community Challenge Fund for third sector organisations.

‘The activities from these projects complement our mainstream Childsmile work in education and health settings.’

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