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New study suggests fillings may not be best treatment for childhood dental caries

By Dental Tribune International
December 12, 2019

LEEDS, UK: Though the role of dental fillings in the treatment of dental caries in permanent dentition is well established, the same cannot be said about primary dentition, as their usefulness is still debatable. A new study has cast further doubt on their role, suggesting that there is no evidence that conventional fillings are more effective in stopping the progress of caries in children.

The multicenter randomized controlled trial compared the clinical effectiveness of three treatment strategies for a length of over 3 years for managing dental caries in primary teeth. Participants aged 3 to 7 years with at least one primary molar with dentinal carious lesion were randomly allocated across the three treatment groups.

This study called the FiCTION (Filling Children’s Teeth: Indicated or Not) trial studied 1,144 children residing in the UK by assigning each participant randomly to one of the three treatment options: 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. The duration of the trial lasted up to three years for some children. On comparison, there were no significant differences in the outcomes between the three treatment groups. 450 participants reported that they continued to experience further caries and pain.

“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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