Effectiveness of a simplified method of managing carious primary molar teeth in young children using preformed metal crowns- Phase 2

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Dental decay (caries) is a highly prevalent disease in Australia and Early Childhood Caries (ECC) is one of the most common chronic diseases of childhood. ECC is the presence of any decayed, missing (due to decay) or filled surface in primary (deciduous) teeth in children 6 years or less. ECC has wide-ranging health and developmental consequences and is often associated with pain, infection and abscesses which can lead to delayed growth, reduced general health, sleep problems and disrupted social and academic development due to school absences. In Australia the epidemiological and service data on prevalence and morbidity for child oral health is patchy; with only 2002 national data available. In 2002 Australian children 0-4 years in the National Child Oral Health survey had a mean of 1.55 decayed, missing or filled teeth (dmft) and 80% of this was active, untreated decay. Of those children with decay (44%), the mean dmft per child was 4.23. In 2006, the Victorian Child Health and Wellbeing Survey found that 21% of 0-3 year olds had experienced toothache and Victorian data available from DHSV shows that of children aged 0-6 years attending public dental clinics in 2009 (n=14,911), 47% had tooth decay (n=7,072), with an average dmft of 2.2. Dental treatment was the 3rd most common cause of hospitalisation for 0-14 year olds in Australia in 2009-10 and the average cost per admission for extractions and restorations was AUD$2508 per child. Importantly the severity of the disease in young children may be increasing as there was a 53% increase in dental Ambulatory Care Sensitive Conditions (ACSC) admissions from 1997/8 to 2004/5 for 0–9 year-olds, with an average annual increase of 7.6%. However, caries rates are higher among the more socially disadvantaged, particularly in childhood, and amongst those living in rural and regional areas. This is also reflected in the ACSC data and rural children have dental related hospital admission rates that are 4 times higher than metropolitan children. After tooth extraction, the potential impacts on child social, emotional, nutritional and developmental experiences are considerable. The significance of this project is to test the effectiveness of a simplified method, reported in the literature, for managing carious primary molar teeth in preschool children without any tooth preparation or local analgesia and therefore making treatment more acceptable to preschool children in a primary care setting. If the approach were shown to be effective, the expected long term outcome would be a reduction in hospital admissions for the management of dental caries in this age group.

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