Use of the Hall Technique in Children With Learning Difficulties

Objectives: Management of dental caries in children with learning difficulties (LD) presents clinical challenges, both technical and with respect to patient management.

Additionally, people with LD have increased plaque levels, poorer oral hygiene and receive less dental care when compared to the general population and there is uncertainty regarding how best to manage caries in this population.

The Hall Technique (HT) is a simplified method of managing carious primary molars with preformed metal crowns (PMCs) which is effective at managing dental caries and is found to be generally acceptable to patients, parents and clinicians.

Objectives: To assess the outcome at 6-monthly intervals for carious primary molars treated with the HT in terms of:
- Restoration survival
- Incidence of pain / infection
Methods: A prospective observational cohort Study (n=50, aged 5 to 12, LDn=16) set in the Community Dental Service in the UK, (dentists n=2). Participants were followed up over 8 years. Carious primary molar teeth were managed using the HT and clinical and radiographic (where appropriate) data collected 6-monthly.
Results: 16 participants with LD (medical histories including, but not limited to, learning diabilities, Autism, Cerebral Palsy, Epilepsy and Down's Syndrome) and an average age of 8.25 years (s = 2.08 years) had 55 carious primary molars treated with the HT and followed up 6-monthly over an average period of 41.06 months (s = 19.83 months). One PMC de-bonded at 30 months and was re-cemented. There were no other restoration failures and no recorded incidence of pain and / or infection.
Conclusions: The Hall Technique is a viable and successful technique for managing dental caries and preventing pain and infection in primary molar teeth in children with moderate to severe learning disabilities.