Protocol for the Hall Technique study: A trial to measure clinical effectiveness and cost-effectiveness of stainless steel crowns for dental caries restoration in primary molars in young children

BACKGROUND: The Hall Technique (HT) is a carious primary molar treatment that does not require local analgesia, carious tissue removal or tooth preparation. The carious lesions in carefully selected teeth are sealed with a stainless steel crown (preformed metal crown). The study aims are to determine the clinical effectiveness, acceptability and cost-effectiveness of the HT for management of carious lesions in young dental patients. METHODS/DESIGN: Children, aged 3-7years, with a primary molar tooth with a carious lesion extending no further than the middle third of dentine, with no signs or symptoms of pulp inflammation or infection, and attending one of three community agencies are recruited. Target sample size is 220. A control tooth with an intra-coronal restoration is sourced from the same mouth. The primary outcome is the period of time free from further treatment. The assessments are scheduled at 6, 12 and 24months. In addition to the clinical assessment, acceptability of the HT will be assessed via questionnaires among patients and their primary carers at baseline, 6, 12 and 24months. Cost-outcome description and cost-effectiveness analysis from healthcare provider and societal perspective will be conducted. DISCUSSION: The clinical effectiveness, acceptability and cost-effectiveness of the HT in the community dental setting will be evaluated. The results of this study will determine the implementation of HT in the management of dental caries in young children.

The centrality of the Australian suburb: mobility challenges and responses by outer suburban residents of Melbourne

Living in the suburbs is founded on mobility, as residents move to the periphery of the city, commute to work and travel for shops, schools and leisure. While there have been numerous studies raising critical questions on the vulnerability of outer suburban residents to loneliness, financial and mortgage stress, the actual experiences and challenges posed by the dependence of suburban life on mobility is rarely singled out for attention. Through purposive sampling and then snowballing, eight outer suburban residents participated in photo-elicited interviewing to detail their lifeworlds and mobility experiences. Problems ranged from getting to work to accessing schools, shops and even neighbourhood services as the suburban car culture was embraced but also constrained patterns of movement. However, there was also an array of positive experiences and alternatives to these patterns, including the pleasures to be found in traffic jams and the suburban environment and local actions to establish new pathways and means of movement as well as set up local employment options. Mobility constraint thereby generated a range of unexpected strategies, as residents exercised their agency to shape their experiences, create alternatives and to build suburban centred lives.