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Paediatric Caries Management — MFDS Part 1 MCQ

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ModeratePaediatric Dentistry PrinciplesPaediatric Caries ManagementMFDS Part 1

A 5-year-old child has an asymptomatic advanced proximal carious lesion in a restorable primary second molar that is not close to exfoliation. There is no swelling, sinus, pathological mobility or radiographic evidence of pulpal involvement, and the bitewing shows a clear band of unaffected dentine between the lesion and the pulp. The child can cooperate with placement of a preformed metal crown. Alongside personalised preventive care, which is the single most appropriate lesion-specific management?

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Correct answer: B — Seal the lesion with a preformed metal crown using the Hall Technique

The correct answer is B. SDCEP recommends the least invasive feasible strategy for caries in primary teeth. An advanced proximal lesion in a restorable primary molar is well suited to the Hall Technique when there are no signs of pulpal involvement and unaffected dentine remains between the lesion and pulp. The lesion is sealed beneath a preformed metal crown without caries removal or tooth preparation. Complete caries removal is less preferred because it increases the risk of pulp exposure and iatrogenic damage. Extraction is unnecessary for a restorable, asymptomatic tooth. Silver diamine fluoride may form part of non-restorative cavity control, particularly when preferred treatment is not feasible, but is not the best option when a durable Hall seal can be placed. Antibiotics are not indicated without spreading or systemic infection and do not eliminate the local cause.

Reference: Scottish Dental Clinical Effectiveness Programme. Prevention and Management of Dental Caries in Children, Third Edition, sections 'Caries management in primary teeth' and 'Hall Technique', 2025. https://www.childcaries.sdcep.org.uk/media/5p4fv1sf/sdcep-prevention-and-management-of-dental-caries-in-children-3rd-edition-guidance-in-brief.pdf