National Elf Service

No bias. No misinformation. No spin. Just what you need!
The Dental Elf

Hall Technique for carious primary molars outperformed standard restorations at 5 years

Derek Richards

In the Hall Technique  carious primary molars are managed by sealing decay under preformed metal crowns without any caries removal, tooth preparation, or local anaesthesia.  The aim of the study was to compare the clinical/radiographic failure rates of the Hall Technique (HT) against General Dental Practitioners’ (GDPs) standard (control) restorations.

This split-mouth study involved 132 children, aged 3-10 yrs and GDPs in Scotland. Teeth were randomized to HT (intervention) or GDPs’ usual treatment (control). There were 264 study teeth with initial lesions, 42% of which were radiographically > half-way into dentin, and 67% of which had Class II restorations.  Annual clinical/radiographic follow-up data were recorded. Ninety-one patients (69%) had 48 months’ minimum follow-up.

Falure at 60 months are shown in the table.

[table id=8 /]

Overall, there were follow-up data for 130 patients (2-60 mos): ‘Major’ failures: HT, 3 (2%); control restorations, 22 (17%) (p = 0.000004; NNT 7); and ‘Minor’ failures, HT, 7 (5%); control restorations, 60 (46%) (p < 0.000001; NNT 3).

They concluded

Sealing in caries by the Hall Technique statistically, and clinically, significantly outperformed GDPs’ standard restorations in the long term.

Innes NP, Evans DJ, Stirrups DR. Sealing Caries in Primary Molars: Randomized Control Trial, 5-year Results. J Dent Res. 2011 Sep 15. [Epub ahead of print]PubMed PMID: 21921249

Does breastfeeding increase Early Childhood Caries?
AI in Dentistry: A Closer Look at Caries Detection
Most popular Dental Elf Blogs Jan – Mar 2023
Written by

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

Add a comment
  • jacob silas

    jacob silas

    13 years ago
    I have advocated the use of Hall Technique for the past two years.The "concept of sealing over decay " has been clinically , a positive mode of treatment
  • Dafydd

    Dafydd

    14 years ago
    Hi there, although we've had a number of enquiries about the Hall Technique, which has included visits from some North American clinicians and teachers, I'm afraid that we don't really know how much people are using it in their individual clinical practice. If it would be helpful to you, we have an updated Hall Manual with a DVD which we would be happy to post to you if you get in touch.
    • 1 reply
    • Thierry BOULANGER
      Thierry BOULANGER 14 years ago
      Hi, I am using the HALL technique in my pedo practice and I'd be glad to receive the manual and DVD. I find that this technique has a place in our child management armamentarium. Best regards, Thierry BOULANGER 71, Route d'Henri-Chapelle 4821 Andrimont Belgium
      • Arie Riem
        Arie Riem 12 years ago
        Hello Thierry, I just read you are going to lecture about "the Hall technique" during a meeting of the BAPD. Well I just want to send my support for that ! I am an enthusiastic user of the technique for many years now. It is good for all dental workers to learn about and perform the Hall technique. Good luck Theirry on 26-04-2014 , I hope you will inspire many collegues!!
  • Meg

    Meg

    14 years ago
    Anyone know of someone in the USA or Canada who does the Hall Technique?
  • Carmen

    Carmen

    14 years ago
    Interesting. Why Not. but the thought of Caries being sealed is kind of squirmish > good thing its just temporary.
    • 1 reply
    • Kerri
      Kerri 14 years ago
      I believe there is mounting evidence showing that sealing over decay can actually arrest the decay process.
      • Derek
        Derek 14 years ago
        Kerri You are right and in evidence-based Clincal recommendations from the ADA on the use of pit & fissure sealants published in 2008 (http://jada.ada.org/content/139/3/257.long). In relation to placing sealants over early (noncavitated) lesions stated : "Placement of pit-and-fissure sealants significantly reduces the percentage of noncavitated carious lesions that progress in children, adolescents and young adults for as long as five years after sealant placement, compared with unsealed teeth" Ref:- Griffin SO, Oong E, Kohn W, Vidakovic B, Gooch BF, CDC Dental Sealant Systematic Review Work Group, et al. The effectiveness of sealants in managing carious lesions. J Dent Res 2008;87(2): 169–174.( http://bit.ly/obEOhd) .