// Chapter · 09
Paediatric Dentistry
Children's dentistry · purpose-built
// Quick answer
Paediatric dentistry decides along two axes: how the decay is arrested, and at what level of comfort the treatment is carried out. Sealing a carious primary molar under a preformed metal crown without drilling was 49% more likely to succeed in a meta-analysis of eight studies (risk ratio 1.49, 95% CI 1.15 to 1.93) and more than six times less likely to fail (risk ratio 0.16, 95% CI 0.10 to 0.27), with the effect clearest in proximal and multi-surface lesions (PubMed 36185501). At Mosdent, preventive work, decay treatment and the sedation or general anaesthesia options are planned together.
// Key takeaways
- 01Sealing decay in a primary tooth can outperform drilling and filling it. Across eight studies drawn from 11 publications, preformed metal crowns placed by the Hall technique were 80% more likely to succeed than direct restorations, and showed similar success to metal crowns placed conventionally (PubMed 36185501).
- 02Silver diamine fluoride is the option that needs no drilling, and its evidence is limited. In a Cochrane review of 29 randomised trials covering 13,036 participants, arrest of caries in the primary dentition averaged 0.86 surfaces (95% CI 0.39 to 1.33) on low certainty evidence (PubMed 39508296).
- 03Evidence does not settle the sedation versus general anaesthesia choice. A Cochrane search found no eligible randomised trial comparing the two in patients under 18, and the authors state that trials are needed to quantify differences in morbidity and cost (PubMed 26413895). The decision therefore follows the extent of treatment, the child's age and their cooperation, and it should be named explicitly in the written plan before travel.
- 04Paediatric dentistry does three jobs: prevention, decay treatment and comfort management. Which route a child takes is set at the first examination from how widespread the decay is and how the child copes with treatment, so a first appointment is booked before any treatment block is scheduled.
// References
- 1.Hu S, BaniHani A, Nevitt S, Maden M, Santamaria RM, Albadri S. Hall technique for primary teeth: a systematic review and meta-analysis. Jpn Dent Sci Rev 2022;58:286-297. PubMed 36185501
- 2.Worthington HV, Lewis SR, Glenny AM, Huang SS, Innes NP, O'Malley L et al. Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults. Cochrane Database Syst Rev 2024;11:CD012718. PubMed 39508296
- 3.Ashley PF, Williams CE, Moles DR, Parry J. Sedation versus general anaesthesia for provision of dental treatment to patients younger than 18 years. Cochrane Database Syst Rev 2015;9:CD006334. PubMed 26413895