In evidence-based pediatric dentistry, what is the preferred management approach for deep caries in a cooperative 6-year-old with limited moisture control?

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When moisture control is limited in a cooperative 6-year-old with deep caries, the best approach is a technique that is forgiving of a not-perfect isolation and minimizes invasiveness. Atraumatic Restorative Treatment uses hand instruments to remove decayed tissue and restores with glass ionomer cement, which tolerates some moisture, seals dentin well, and supports pulp vitality while preserving tooth structure. If a conventional restoration is chosen, it should be done with proper isolation to optimize the seal, again favoring materials like glass ionomer that perform better in moist conditions. If the tooth will need full-coverage protection due to extensive decay or structural loss, a stainless steel crown offers durable, quick coverage that is less sensitive to moisture control and helps protect the tooth long-term. Delaying treatment, extracting, or proceeding with a resin-based restoration without adequate isolation would increase the risk of restoration failure and pulp problems in this scenario.