The purpose of this section is to present a method of controlling dental caries, specifially ECC, in PRE-cooperative children, in other words children not yet ready to fully cooperate during dental treatment, using glass ionomer restorative material with Alternative Restorative Therapy.

The term Alternative Restorative Therapy (ART) refers to providing restorative therapy to children in a way that NO pain is involved. In particular, for this course, this means that an anesthetic is not used and the specific restorative therapy provided is still accomplished without eliciting pain, and the lesions are restored using a resin-modified glass ionomer (RMGI). The removal of the caries from the tooth is accomplished very carefully and painlessly, using hand instruments or a slow-speed handpiece. These excavated lesions are restored with RMGI and light-cured, which is also done without causing pain. These restorations are often referred to as scoop-and-fill restorations or band-aid restorations.

The procedure is very well suited for application in disadvantaged communities since the costs are small and sophisticated equipment is not necessary. It can also be an advantageous therapy to provide in private practice dental offices, as it avoids the need for major restorative dental work under either a local or general anesthetic. When this technique is used properly and in the proper situations, it provides a much more acceptable introduction to dental care than the conventional "inject, drill and fill."

**Excerpted from "Access to Baby and Child Dentistry - A Manual for Dental Providers" from the Department of Pediatric Dentistry, University of Washington.