Management of Carious Primary Molar Teeth by UK Postgraduates in Paediatric Dentistry

Abstract

To assess the treatment preferences amongst UK postgraduates (PG) in Paediatric Dentistry for a symbolic child with sample case history of differing caries severity in a primary molar tooth. All Paediatric Dentistry PG were contacted by e-mail and asked to participate in an on-line structured questionnaire. The survey described four different case scenarios of a 5-year-old child, presenting with a mesio-occlusal cavity in tooth 85 with varying symptoms and signs. Treatment options were listed and participants asked to select the single most preferred treatment for each case. The same scenarios were also presented for both non-anxious and dentally-anxious children and differences were analysed by Chi2 analysis. Responses were received from 38/59 (F: 31; M: 7) PGs. The preformed metal crown (PMC) with Hall technique was selected as the option for patients with no indication of pulpal involvement by 4/38 and 20/38 for non-anxious and dentally-anxious patients respectively (Chi2=27.56, P=0.001, 1 dof). For a tooth with signs of pulpal involvement or symptoms the options selected were (non-anxious, dentally-anxious): zinc-oxide eugenol pulpecotomy and PMC 8/38, 2/38 (Chi2=9.85, P=0.002, 1 dof); local analgesia extraction 15/38, 2/38 (Chi2=27.22, P=0.001, 1 dof) and extraction under a general anaesthetic 0/38, 16/38 (Chi2=42.00, P=0.001, 1dof). There was no consistency of response by PGs in Paediatric Dentistry within the UK. The Hall technique appeared to be a favoured option for treatment of an asymptomatic carious primary molar tooth in dentally-anxious child patients. Extraction was preferred for those with pulpal involvement for both non-anxious and dentally-anxious patients, although the suggested mode of extraction differed.