Survival of Teeth Restored with Atraumatic Restorative Treatment in a Pediatric Rural Population

In the 1980s, a pilot study conducted in Tanzania demonstrated a reduction in the need for tooth extraction after removal of soft demineralized dentin from dental cavities that were then filled with polycarboxylate cement [1]. Remarkably, only one of the twentyeight permanent teeth treated in this manner was extracted while the remainder was asymptomatic nine months after treatment [2]. This technique became known as the atraumatic restorative treatment (ART) [3]. Since this initial study, the technique has evolved and been refined to utilize hand instruments to enlarge the orifice of small cavities to be restored with glass ionomer material. ART offers a method to manage and prevent caries progression in challenging environments such as remote areas, field practices, schools, village halls or in community health centers with limited equipment, and has been endorsed by the World Health Organization [4].