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Non-restorative cavity treatment: should this be the treatment of choice? reflections of a teacher in paediatric dentistry René JM Gruythuysen Dental Update 2024 46:3, 707-709.
Authors
René JMGruythuysen
Retired Dentist, Post-academic Teacher Paediatric Dentistry, Tandzorg.nl, Rotterdam, The Netherlands
Non-Restorative Cavity Treatment (NRCT) is not favoured by many paediatric dentists. However, perhaps it should be the treatment of choice rather than confronting child and parents with a restorative, symptomatic, often less child-friendly approach. Does the child have a right to a viable biological treatment option, because solving a biological problem, basically caused by neglect, with technical solutions is ethically not defensible in all cases? Restorations simply mask the caries activity. What matters is the oral health and the well-being of the child. How can this best be served?
CPD/Clinical Relevance: This paper might serve as a discussion document for a group of oral health providers deciding practice policy with regard to the management of caries in primary teeth.
Article
Some definitions and their corresponding acronyms start this section: Non-Restorative Cavity Treatment (NRCT) is a non-restorative method of controlling dentine lesions. It sits alongside Non-Operative Caries Treatment Programme (NOCTP), a method of controlling enamel lesions. Taken together, this non-restorative management of enamel and dentine lesions is called Non-Restorative Cavity Control (NRCC).1
NRCT manages cavitated caries lesions without placing fillings by making the lesions cleansable. This was first advocated for use in young children by GV Black in 1908.2 His non-restorative approach was based on his belief in plaque control to manage caries and his insistence that the most important thing in treating children was not to frighten them. In addition, in 1908 the filling materials available were amalgam and gold inlays, neither really suitable for use in primary teeth. The method is still relevant today because it is a biological, child-friendly approach to reduce, and preferably stop, the caries activity.
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