Sir, I was distressed to read the paper by Threlfall et al. (BDJ 2005; 199: 453–455). The use of preformed crowns has been part of the armamentarium of dentists for more than half a century and should have been included in the curriculum in dental schools for most of that time. Several years ago the unpublished results of a small study carried out with GDPs showed that, when shown how, even totally inexperienced practitioners could fit and cement a preformed crown on a prepared tooth in 11 minutes.

The undoubted long-term success of these restorations was referred to and the technique necessary for their placement is far simpler and less critical than that for intra coronal restorations. If their use cannot be recommended for all children then they are certainly the technique of choice for co-operative children with extensive caries.

If preformed crowns are still not used it may be because in the dental schools the students are still not being adequately taught when and how to. This results in them having insufficient clinical experience and they therefore lack the confidence to carry out one of the less demanding techniques in the care of children.