Active ImageAtraumatic Restorative Treatment (ART or PRAT in Spanish) is a simple method to treat dental caries in situations where traditional cavity preparations are not feasible. The technique was developed over 10 years ago and has been proven to be an effective treatment option. It involves the removal of soft, demineralized tissue followed by the restoration of the tooth with fluoride-releasing glass ionomer.

ART/PRAT systems have been successfully employed all over the world as it does not require electricity, running water, or anesthesia. PAHO, with the support of the Inter-American Development Bank (IADB), demonstrated the cost-effectiveness of ART/PRAT compared to amalgam restorations in three LAC countries over three years. Longer-term studies are currently underway. Results of this study can be found under the Related Methods section.

This section reviews the history, research and development of the technique, practical purposes, and current studies and trends.


Scientific and Technical Publications

pdf  La Salud Oral de los Niños de Bajos Ingresos. Procedimientos para el Tratamiento Restaurativo Atraumático. (979,08 kB)  

OPS. BID. 2009. Informe final. Saskia Estupiñán-Day, Trevor Milner, Marisol Téllez

En el presente estudio, las técnicas básicas de evaluación económica, particularmente las técnicas de análisis costo-efectividad (ACE), se utilizaron para evaluar la práctica de la técnica PRAT. La investigación tuvo como objetivo introducir la técnica PRAT en los servicios de atención dental del gobierno en Panamá, Ecuador y Uruguay como una modalidad de tratamiento restaurador para el tratamiento de caries tanto en los dientes primarios como permanentes, ampliando así la cobertura de los servicios bucodentales a nuevas poblaciones de niños, incluidos los que actualmente carecen de acceso a tratamientos convencionales en base a Amalgamas.

pdf Atraumatic Restorative Treatment (ART) to the Rural Population: A GOI - WHO Collaborative Programme (913.55 kB)

WHO, Mahatma Gandhi Post graduate Institute Of Dental Sciences & Government of Puducherry Institution, 2007. Report of use of ART in rural Puducherry grammar schools and colleges. Evaluation of cost effectiveness, and retention of fillings.

pdf Oral Health of Low Income Children: Procedures for Atraumatic Restorative Treatment (PRAT) (2.6 MB)

PAHO, 2006. Basic techniques of cost-effectiveness analysis (CEA), PRAT in government dental care facilities in Panama, Ecuador and Uruguay, thus extending coverage of oral services to those without access to conventional Amalgam-based treatment.


Training Materials                                                               

pdf Atraumatic Restorative Treatment (ART) for Tooth Decay: How to organize and run an ART training course (4.77 MB)

WHO, 2000. Educational material for facilitators of ART training based on experience gained in over 30 countries.

pdf Practica de Restauracion Atraumatica (PRAT) para la Caries Dental - Como Organizar un Curso PRAT (2.68 MB)

OMS, Escuela de Odontología de la Universidad de Nijmegen, 2001. Materiales educativas para entrenar facilitadores en la técnica PRAT basado en experiencia recibido en más que 30 países. 

Additional Resources

Videos