In September 2021, myself (Harriet Willings) and my colleague James Cook, signed up to participate in the ‘SCRiPT’ Trial – ‘Selective Caries Removal in Permanent Teeth’. This is a national study being carried out by the University of Aberdeen which aims to find evidence to support the ideal way in which a filling should be carried out. Let us explain…
Dental decay is when part of the tooth becomes rotten and soft. This can spread through the tooth, eventually getting deeper towards the nerve, which causes toothache. In order to fix the tooth, we must remove the decayed part and rebuild the tooth structure with filling material.
By drilling out the decayed part of the tooth, this can irritate the nerve causing pain. This is understandably more likely to happen when the decay is deeper into the tooth and closer to the nerve. This then needs root canal treatment to fix.
The SCRiPT trial is looking at the two ways in which we can remove dental decay. The first way, the more ‘traditional’ way, is to remove the entirety of the decayed area of tooth tissue, even if this goes straight into the nerve, resulting in root canal treatment. This is known as ‘complete caries removal’.
Alternatively, in some cases we are able to remove the majority of the decay, but leave a layer of decay over the nerve, to try and reduce the risk of irritating the nerve. This is known as ‘selective caries removal’.
In the SCRiPT trial, we provide a filling either by complete or selective caries removal and then monitor the survival of the tooth (or the need for root canal treatment) over 3 years. If there is strong evidence showing one method results in significantly less need for root canal treatment following the filling, this will revolutionise the way in which simple dentistry is undertaken.
Since September 2021 James and I have been recruiting patients with dental decay. We undertake a rigorous consent process and take appropriate x-rays. The SCRiPT computer system then randomises whether we are to provide ‘complete caries removal’ or ‘selective caries removal’. Following the provided treatment, we have then continued to monitor these teeth at routine check-ups.
As such a long-standing practice, we feel that it is very important to contribute to the evolution of dentistry. It is important to us to help move our profession forward, with up-to-date research to help provide our patients with the best possible treatment for many years to come.
If you would like further information or think you may be able to partake in the study, please feel free to contact on 01924 211234.
