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A quantitative and qualitative investigation into the management of carious primary molars by foundation dentists in primary care in the South East of England


Introduction Dental caries is the most common reason for hospital admission of children aged 5-9 in the UK. Better management of caries in primary molars would reduce the number of children requiring treatment in hospitals; however, little research has been done into why primary care clinicians do not use an evidence-based approach to caries management for deciduous molars.

Aims The aim of this paper is to identify the rationale behind caries management techniques used in primary care, as well as the choice of materials and long-term success of restorations placed.

Materials and methods Use of a retrospective audit and a focus group with primary care clinicians to provide an insight into the management of carious primary molars and the barriers to achieving gold standard care.

Results Glass ionomer cements (GICs) were the restoration of choice in primary care. Lack of time, equipment availability and clinician inexperience were cited as to why Hall crowns were not commonly placed.

Conclusions The barriers to gold standard management of carious primary molars in practice are wide-ranging but tend to focus on the limitations of NHS care under the units of dental activity system. Lack of time and cost of materials encouraged clinicians to adopt a ‘quick fix' approach in GIC.

Key points

  • To appreciate the challenges for primary care practitioners in treating carious primary molars.

  • To discuss the barriers to gold-standard care in primary practice.

  • To identify the qualities of a material that would overcome the hurdles faced by clinicians in primary care, subsequently improving patients' long-term outcomes.

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Authors and Affiliations



Saud Almaeen devised the project, under supervision of Paul Ashley and with assistance from Zoe Buontempo in collecting the data required. Zoe Buontempo wrote the manuscript with contributions and supervision from Saud Almaeen and Paul Ashley.

Corresponding author

Correspondence to Zoe Buontempo.

Ethics declarations

The authors declare no conflicts of interest.

Ethical approval was obtained from the UCL Research Ethics committee, Project ID: 21963/002. Focus group participants gave consent to participate. This paper is based on elements of a larger project, ‘SMART composite restorations of carious primary molar teeth after minimal caries removal', a doctoral thesis from the Eastman Dental Institute at UCL.

Data availability

The data that supports the findings of this study is openly available on UCL Discovery at,695/.

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Buontempo, Z., Ashley, P. & Almaeen, S. A quantitative and qualitative investigation into the management of carious primary molars by foundation dentists in primary care in the South East of England. Br Dent J 236, 625–629 (2024).

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