Hall Technique

Hall Technique (HT) is a minimally invasive restorative option for primary teeth with severe decay and/or hypomineralization without numbing (shots), tooth preparation (drilling), or sedation (general anesthesia/IV deep sedation). HT is an evidence based procedure with 5 randomized control trials, with clinical efficacy equivalent to the conventional surgical approach to stainless steel crown (SSC) placement. It originated in Scotland in the 1990’s where general practitioner, Dr. Norna Hall, accidentally discovered that when she sealed her pediatric patient’s carious lesions within a glass ionomer cement under a SSC, the lesions became arrested (inactive) once starved of the carbohydrate substrate necessary to get worse/deeper. Sealing the lesions allows the vital pulp to lay down reparative dentin and retreat/wall itself off from the carious lesion. The procedure is well tolerated by most pediatric patients and is a welcome alternative to the more invasive surgical approach.

Indications

Decayed primary teeth
Asymptomatic or reversible pulpitis
Clear band of dentin between the carious lesion and the pulp on a radiograph
Newly erupted first permanent molars with severe molar incisor hypomineralization (MIH)

Contraindications

Decay extends into the nerve
Pain or infection (Irreversible pulpitis)
Unrestorable teeth
Patients where the airways cannot be protected due to very poor cooperation (will not open mouth, cannot stay still for placement of the crown, will not tolerate anything being placed into the mouth like a mirror, gauze, etc.)