Effectiveness of treating of early childhood dental decay using minimally invasive Atraumatic Restorative Treatment-based approach

Children with early childhood dental decay (<72 months age) on a wait list for treatment under general anaesthesia at the Oral Health Centre of Western Australia (OHCWA) will be randomised into standard care (oral rehabilitation under general anaesthesia) or test care (minimally invasive dental treatment using the Atraumatic Restorative Treatment approach). Children in the test group will be treated by dental therapists with at least 5 years post-graduate experience, using the ART-based approach, using hand instruments to remove dental decay and restoring of the prepared cavity with glass-ionomer cement or stainless steel crowns using the Hall technique. The procedure will take approximately 30 minutes for each appointment for treatment and will be undertaken in school dental service dental clinics. Test group children will also be provided with preventive care including fluoride varnish on the remaining at risk tooth surfaces and fissure sealing of at risk chewing tooth surfaces at baseline during the 30 minute appointments, and at each recall checkups. Six monthly dental checkups will be instituted as part of the oral care program to monitor changes in oral health status and further appointments made to affect preventive care and repair of restorations as needed for 12 months post enrolment. The type of treatments provided and attendance at appointments will be reviewed based on clinical notes.