Acceptability of different caries management methods for primary molars in a RCT

Background: More conservative techniques for managing dental caries including ‘partial’ and ‘no caries removal’ have been increasingly of interest.

Aim: To compare children's behaviour and pain perception, also technique acceptability (parents and dentists), when approximal dentinal lesions (ICDAS 3–5) in primary molars (3–8-year-olds) were managed with three treatment strategies; conventional restorations (CR), hall technique (HT), and non-restorative caries treatment (NRCT).

Design: Secondary care-based, three-arm parallel-group, randomised controlled trial, with 169 participants treated by 12 dentists. Outcome measures: child's pain perception (Visual Analogue Scale of Faces); behaviour (Frankl scale); and parents' and dentists' treatment opinions (5-point Likert scales).

Results: Children showed more negative behaviour in the CR group (37%) compared to NRCT (21%) and HT (13%) (P = 0.047, CI = 0.41 to 0.52). Pain intensity was rated ‘very low’ or ‘low’ in 88% NRCT, 81% HT, and 72% CR (P = 0.11, CI = 0.10 to 0.12). NRCT and HT were ‘very easy’ or ‘easy’ to perform for >77% of dentists, compared to 50% in CR group (P < 0.000). There were no statistically significant differences in parents' rating of their child's level of comfort (P = 0.46, CI = 0.45 to 0.48).

Conclusions: Dentists reported more negative behaviour in CR group. For all techniques, children's pain perception and dentist/parent acceptability were similar.