Abstract
The prevalence of dental caries in children worldwide is very high. This PhD thesis investigated and compared the effectiveness of three oral healthcare protocols - the Conventional Restorative Treatment (CRT), the Atraumatic Restorative Treatment (ART), and the Ultra-conservative Treatment (UCT) - in preventing and treating dentine carious lesions in mixed-dentitions of 6-7-year-old schoolchildren from Paranoá, a deprived suburban area of Brasília, Brazil.
This thesis presents clinical trials regarding: the survival of CRT and ART restorations in primary molars; the survival of primary molars that presented intact and defective restorations; the caries-preventive effect of supervised tooth brushing, composite resin and ART sealants; the survival of retained composite resin and ART sealants using different assessment criteria; and the long-term effect of supervised tooth brushing on levels of visible plaque and gingival bleeding among schoolchildren.
The findings of this thesis support the use of ART restorations as a viable option to replace amalgam for managing cavitated dentine carious lesions in single-surfaces in primary molars and daily supervised tooth brushing at school and the application of ART sealants for preventing the occurrence of dentine carious lesions in first permanent molars. They further question the need to re-restore defective restorations in primary molars and show the benefit of supervised tooth brushing for obtaining a clean dentition in this age group.
Oral healthcare protocols that are more accessible to the populations and that act on the causes of the disease, such as ART and UCT, seem to be the best options to reduce the burden of dental caries and to improve children’s oral health and quality of life.
