THE HALL TECHNIQUE: WHAT DOES OVER 20 YEARS OF EVIDENCE TELL US?
NICOLA INNES
I initially qualified as a Registered General Nurse, then gained a BSc in Life Sciences followed by an intercalated BMSc in Cellular/Molecular Pathology and BDS(hons). I spent seven years as a General Dentist in Scotland then completed a PhD based on a randomised control trial investigating the Hall Technique whilst part-time in practice and part-time at the University of Dundee. With over £7M grant capture, and around 100 publications in peer reviewed journals, my research is internationally recognised within cariology (minimal intervention), paediatric (Child Friendly) dentistry, marginalised communities and evidence based dentistry and I have undertaken 2 UK-wide child dental research projects, the FiCTION Trial where we looked at 3 different ways of caring for children’s carious primary teeth in general dental practice and the ongoing BRIGHT Trial looking at whether a school lesson and text reminders improves young people’s toothbrushing behaviour. I have participated in other UK-wide trials as well as ones based in Germany, Lithuania, Australia, Brazil, US and New Zealand, co-authored several Cochrane reviews related to cariology and sit on several national guidance development groups. In Dundee I co-led implementation of a new undergraduate curriculum and was Associate Dean for Learning and Teaching for 4 years. I took up the position of Dean of Cardiff Dental School at the beginning of August 2020 and lead the Improving Clinical Dentistry research group.
ABSTRACT
The Hall Technique was discovered through a chance finding over 20 years ago in Scotland. It is a simple but effective method for managing carious primary molars. A stainless steel or preformed metal crown (PMC) is cemented onto the tooth using glass ionomer luting cement. Our understanding of the carious process has improved and this, together with evidence for the Hall Technique’s clinical success, it is now widely accepted, taught and extensively used across the globe. The Hall Technique differs from the original method for placing PMCs. No local anaesthesia is placed, no carious tissue removed, and no tooth preparation carried out. The technique seals the carious biofilm under the restoration, away from the oral cavity, changes the environment and arrests the caries process. Sealing deprives the microbiota of substrate and other factors they require to thrive in a carious state. The Hall Technique uses PMCs that can be pushed over the tooth. This, together with the glass ionomer, helps to secure the seal, maximising the lesion’s arrest and stopping the progression of the carious lesion.
This lecture will discuss the discovery and history of the Hall Technique and will focus on the evidence that has emerged around it.
