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References

Office of the Chief Dental Officer. Standard operating procedure. Transition to recovery. 2020. https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/06/C0575-dental-transition-to-recovery-SOP-4June.pdf (Accessed July 2020)
The Hall Technique: A minimal intervention, child centred approach to managing the carious primary molar. 2015. https://en.wikipedia.org/wiki/File:HallTechGuide_V4.pdf
Hussein I, Al Halabi M, Kowash M Use of the Hall technique by specialist paediatric dentists: a global perspective. Br Dent J. 2020; 228:33-38 https://doi.org/10.1038/s41415-019-1100-2
Innes NP, Clarkson JE, Douglas GVA Child caries management: a randomized controlled trial in dental practice. J Dent Res. 2020; 99::36-43 https://doi.org/10.1177/0022034519888882
Al-Halabi M, Salami A, Alnuaimi E Assessment of paediatric dental guidelines and caries management alternatives in the post COVID-19 period. A critical review and clinical recommendations. Eur Arch Paediatr Dent. 2020; https://doi.org/10.1007/s40368-020-00547-5

COVID-19 paediatric caries management: the newcastle ‘Hall’ approach

From Volume 47, Issue 8, September 2020 | Pages 688-689

Authors

Christopher C Donnell

Dental Core Trainee in Paediatric Dentistry Newcastle, UK

Articles by Christopher C Donnell

Ben Dixon

General Professional Trainee in Paediatric Dentistry Newcastle, UK

Articles by Ben Dixon

Nichola CH Lush

Consultant in Paediatric Dentistry Newcastle, UK

Articles by Nichola CH Lush

Article

As we traverse the early stages of our Transition to Recovery, we are still attempting to limit the amount of aerosol generating procedures (AGPs) undertaken, and thereby reduce the risk of COVID-19 transmission.1 In paediatric dental terms, this limits the conventional methods of caries management in deciduous molars to the Hall Technique.2

For those not familiar with the Hall Technique, a preformed metal crown (PMC) is typically ‘seated over a tooth with no caries removal or tooth preparation of any kind, and local anaesthesia is not required.’2 This may or may not require the use of interim elastomeric orthodontic separators (EOSs) to create space around the tooth, which remain in situ for three-to-five days, to open tight interproximal contacts.1,3

Conventional methods of caries management in primary molars have ranged from preventive measures alone to PMC placement and, ultimately, complete caries removal by mechanical means.4 The FiCTION trial was a unique and important study which highlighted no evidence of a difference in clinical effectiveness between the above-mentioned methods of caries management.4 Ergo, non-AGP approaches in the current climate are an effective, robust and well-established method of managing caries in the paediatric populace.5

As less invasive methods of caries management are being pressed, such as the use of silver diamine fluoride (SDF) and indeed Hall crowns, we feel obliged to share our modified approach to the Hall Technique, which we employ to great effect at Newcastle Dental Hospital.

The original Hall Technique advises a period of three-to-five days between EOS placement and crown fit. We have established, however, that a period of 30 minutes is sufficient, from separator placement to successful PMC fit. While the success of placing a PMC via the Hall Technique does indeed require appropriate case selection, excellent patient management and long-term monitoring,1 we have the ability to: eliminate the need for re-attendance, complete the assessment and management in one sitting, reinforce crucial prevention advice and discharge back to practice in one fell swoop, without the need for needle, drill or suction.