Alternative treatment options are available when patients may not be able to tolerate traditional restorative treatment that involves numbing and drilling. These can also be utilized if a parent or patient would just like to avoid the numbing part of receiving dental treatment. Not all teeth are candidates for these options; however, if your child is a candidate for one or more of these options, they will be presented and discussed. Feel free to also ask about any of the options.
ART Restorations (Atraumatic Restorative Technique)
This technique involves the placement of a filling without needing to numb the tooth. Slow speed excavation and hand instruments can be used to remove soft decay without causing pain to the patient. A tooth-colored filling is placed after sufficient decay has been removed. This technique is typically indicated for the young apprehensive patient with an easily accessible cavitated lesion, who will not tolerate local anesthesia.
Silver Diamine Fluoride (SDF)
SDF is a liquid that can be used to slow down or stop a cavity from progressing. SDF has many applications. It can prevent progression in the early stages of cavities or slow down the growth of a cavity on a tooth nearing exfoliation so it can fall out without causing additional problems. SDF can be used to stabilize cavities for a child who is not yet ready to tolerate other forms of treatment. It can also be used to minimize sensitivity in teeth effected by enamel hypoplasia. The main adverse outcome of SDF use is staining. SDF causes effected areas to which it is applied to turn permanently black.
SMART Restoration (Silver Modified Atraumatic Restorative Technique)
SMART restorations involve a step beyond the use of SDF. Once lesion arrest is noted following application(s) of SDF, a tooth-colored restorative material can be added over the site of application to minimize further debris and/or plaque retention. This reduces the risk of further cavity progression.
Hall Technique Stainless Steel Crown
Traditionally, placement of a stainless-steel crown involves numbing the tooth, removing the cavity, and preparing the tooth to allow placement of the crown. The Hall technique involves placement of a stainless-steel crown without numbing or cavity removal. The technique relies on the principle of sealing off the decay causing bacteria from the food source they need to make the cavity grow. This technique allows for the placement of a highly dependable restoration on a primary molar and avoids the part that patients fear the most, the numbing.
