We often hear of different branches or if you like different specialties of dentistry and when I remember conservative dentistry I wonder if the word conservation is still relevant when we consider what it entails to prepare an abutment or several teeth to fabricate crowns and bridges in order to preserve human dentition. The question is do we really conserve the teeth we claimed to preserve?
Let's begin this way: when a tooth has a hole or the crown damaged and the clinician considered it vital then he opts for prescribing a number of appliances namely: inlay, pin lay, pin ledges, crowns, bridges etc. Any attempt to make any of the aforementioned conservative restorations results in further reduction of the crown thereby exposing the tooth to more danger by loss of supporting tooth structure. For instance if a crown was prescribed the tooth structure has to be further reduced. A lot of teeth have been lost or weakened in this process. At least a third of the total tooth structure of other healthy teeth is removed if a bridge is prescribed. How can we confidently say that teeth have been conserved? The crowns or bridges made are held to the remaining tooth structure by dental cement which often may lose its grip with time resulting in patient's continuous visit to the clinic. It should not sound as an evil but unless the tooth can not be saved by other means of treatment conservative procedure should be sparingly used. It has been reported in the literatures that 2/3 of a tooth supporting structure is lost when they are prepared for crowns or bridges. Should we still continue to pursue the objectives of conservative dentistry?
Root Canal Therapy (RCT) is definitely a practice that has saved millions of teeth globally but we cannot say of conservative appliances like crowns and bridges. Having said this are conservative appliances no longer suitable in contemporary dental practice? Of course not.
It behoves the dentist to weigh several options before decisions are made bearing in mind the several immediate and long term consequences of conservative appliances.
Saturday, May 30, 2015
CONSERVATIVE DENTISTRY-Still A Relevant Practice?
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