According to statistics data collected by researchers from Manchester University about 40% of 5 year old children in UK have tooth decay and 10% of them are being treated with fillings.
Experts acknowledge there is a wide variation in children dental care and there are no strict treatment guidelines and dentists have to rely on their professional judgement and experience to consider whether to intervene and provide treatment to children with signs of tooth decay.
If a child goes through an unbearable pain and the parents are positive that their child will cope with the treatment, then the choice may be clear. However, it can sometimes be very difficult to decide the most advantageous course of actions treatment-wise, particularly if we consider cases when tooth decay is not causing any symptoms and that their tooth will ultimately fall out naturally by the time they are 11. This suggests the filling may achieve nothing but only expose the child to the discomforts of an anaesthetic injection, sound of a drill, etc.
Another survey data reveals that only 6% of the parents would consider filling treatment for their child with symptomless decay in a baby tooth. In addition, a third of parents would want for the dentist to monitor the tooth with the problem, but provide no treatment.
One of the investigators Dr. Gail Topping, of the University of Dundee, said: “This is a really big question to answer. At the moment there is no clear winner and we do not know which is best to recommend. There is no guidance or mandate. At the moment, dentists are doing what they believe is the right option for the child on a case by case basis.”
Dr. Kamini Shah from the British Association for the Study of Community Dentistry (BASCD) explains: “There are two schools of thought, one being that baby teeth can cause pain and sleepless nights and so dentists should fill. The other is that actually the evidence around filling baby teeth is questionable. Sometimes you need to adopt a pragmatic approach rather than go in with all guns blazing. That way you gain the child’s confidence and can work on prevention. You do not want to upset the child and make them phobic of future treatments.’’
One thing is indisputable, dentists would welcome evidence-based guidelines because of the fact the treatment decision can be sometimes difficult to make. Further research is scheduled into the topic.