DHBs bring in seal-and-kill option for tooth decay instead of injection and drilling

A pain-free and revolutionary new way of fixing tooth decay in children is being rolled out by some district health boards.

The Hall Technique - created by Scottish dentist Norma Hall several decades ago - simply glues a stainless steel cap to the decay-affected tooth.

What is deemed "radical" by those in the industry is that the painful process of digging the decay out of the tooth no longer happens.

Dr Hall discovered that by capping the tooth, trapping in the bacteria, the decay can no longer feed itself so eventually dies. It meant there was now no need to carry out painful extractions, fillings or repairs of fillings.


Waikato District Health Board was the first to use the scheme in 2012. Clinical trials have also since begun in Gisborne and Northland.

Waikato DHB principal dental officer Rob Aitken said during 2015, 4279 caps were placed on children's teeth, compared with 4072 tooth extractions in patients under 17. However, 1185 children needed surgery to have their teeth pulled out, with 7 per cent of those patients under 3, and a further 20 per cent between 3 and 4.

Children as young as 2 have also had their teeth pulled because of the severity of their condition.

Dr Aitken said when Dr Hall created the capping system, the dental profession thought she was "mad".

Dr Aitken said it was deemed "radical" as the decay was not removed.

South Auckland, Northland, Gisborne, Waikato and Lower Hutt were the worst-performing DHBs when it came to tooth decay, he said.

"And again it's the lower socio economic groups that pose the greatest risk and where the water is not fluoridated. Taumarunui and Cambridge don't have it, while Huntly and Ngaruawahia are in the process of getting it."

The technique, along with the overarching Caries [Decay] Management System, will be discussed at The Big Day Inn - a two-day dentistry conference beginning in Hamilton on Thursday bringing in more than 285 dentists from New Zealand, Fiji and Canada.

Associate Professor Peter Dennison, most recently of the University of Sydney's Dental School, is a guest speaker.

Dr Dennison said the Hall technique was "atraumatic technique for treating a caries lesion" especially useful in young or anxious children.

"So you don't have to use an injection which upsets a lot of children, you don't have to pick up a drill which is noisy and vibrates.

"The child can simply bite a stainless steel crown into place. It's a very simple technique and much less traumatic for the child with baby teeth."

Pulling teeth

• 56,871 children were assessed in Waikato DHB dental clinics in 2015
• Of those, 4082 teeth were pulled from patients under 17
• 4279 stainless steel caps placed
• A further 1185 children/adolescents needed general anaesthetic/surgery to have teeth pulled out.
• In those 1185 surgeries, 2361 teeth were taken out [906 at Te Kuiti hospital, 904 at Waikato Hospital, 485 at Thames hospital and 66 in other facilities].

Luca's loving the chair

7 year-old Luca Huirama has his cap and teeth checked by dental therapist Claire Newton at the Waikato DHB Fairfield Dental Clinic. Photo / Brett Phibbs
7 year-old Luca Huirama has his cap and teeth checked by dental therapist Claire Newton at the Waikato DHB Fairfield Dental Clinic. Photo / Brett Phibbs

Luca Huirama was always scared of the dentist - which his mum, Lee, knew as the "murder house".

But now, Luca loves going to the dentist and it's all because he doesn't have to fear the drill or the long scary needle.

Luca needed his first filling about a year ago. But thanks to the Waikato DHB taking up the Hall's Technique - capping the tooth, instead of ripping or drilling the bacteria out - there were no loud noises and no agony for hours afterwards.

Mrs Huirama said they learned about the new filling techniques and the family brushed up on their dental cleaning regime. The kids enjoyed it so much they were even flossing daily.

She recommends the capping practice to everyone.

"It's a free service - why wouldn't you do it for your children and get them regularly seen. It saves in the long run. And seriously it does not hurt. [Luca] doesn't even remember it, that's how [non] traumatic it was.

"All they had to do was clean the tooth and put the glue in the stainless steel cap and then hold it in place for a few seconds. I was surprised how easily it fitted on. And now he's a pirate."