Pediatric dental crown – Hall technique – Why don’t we use it more?

The Hall Technique is a noninvasive way of managing carious primary molars. It utilizes the cementation of metal crowns (stainless steel crowns) with glass ionomer luting cement. Clinical trials show the superiority of the technique but few use it.  I don’t know why.   My guess is that humans tend to believe if we have done more work we should accomplish more.  Thus the hall technique which is much easier than decay removal, pulpotomy, and/or stainless steel crown placement is thought to be less effective (until you look at a study).

Dental research on the topic include the following; Innes 2007   van der Zee 2010   Fontana 2012     Santamaria 2014

Ludwig JADA 2014

RCT 5 year follow up Teeth with significant decay do better with Hall technique Innes 2015 BDJ retrospective case-note follow-up of 5-year RCT

Another RCT of 5 years showing that the Hall technique is better for tooth survival, cost, and fewer complications. Schwendicke J Dent Res. 2018

Two other reasons the Hall technique is not popular

One reason is that few dentists know of the procedure. As far as I am aware dental schools do not teach the hall technique to dental students, pediatric dentists do learn of it though in most programs. In the places it is taught, I doubt it is given much time or credit. The second reason is almost certainly money. Using this technique would save the public a lot of money which means dentists would make less. It would especially impact pediatric dentists. This is something that almost anyone can handle thus the number of dentists that need to refer to a pediatric specialist would plummet. I am sure that last one will offend many but you can not be intellectually honest without admitting that the things that make us money have some bias over our thinking.