What is restorative dentistry?
Taking your teeth for granted is something that we all do. Since we have extraordinarily little consciousness of what lies just inside the lips, the only time we start to take notice is when something does not feel quite right, or worse, when something becomes painful.
The mouth is an amazing assembly of hard and soft tissues that wards off bacteria, permits food and fluid intake, allows speech and breath, and is almost self-maintaining, to a point. Our mouths need assistance to last as long as we do, and half of the care equation is oral health maintenance at home. Brushing flossing and mouth rinses are well known aids to keeping your teeth healthy.
The other half of the equation is the art and science of dentistry.
All of the complex mechanisms of the mouth have potential for slowly falling into disrepair, and dentistry has a whole bag of tricks to help reverse the process. This is called restorative dentistry, and the goal is to restore the mouth to its best native function.
The optimal performance of chewing, for example requires a complex interplay in 3 dimensions of bones, ligaments, inclined and flat surfaces and interdigitating of the specific angles of cusps to allow freedom of movement in the correct directions to promote good digestion.
Each part of the tooth, or whole teeth can be repaired or replaced if something goes amiss. The practice of restoring the mouth to proper form and function is called restorative dentistry.
Dental science has developed over many years, and dental materials have evolved from simple easily found primary elements to compounds that are wear and tear resistant and have optimal appearance characteristics.
The category of restorative dentistry refers to the use of these materials to restore the mouth and dentition to proper form and function to maintain health and beauty. Teeth function in the act of communication, appearance, and food intake, and beautiful teeth are esthetically prized.
As we age, the teeth also age, with cracks, cavities, stains, and gum disease taking their toll. As teeth change, the support that they give to the face changes and the lower third of the face can collapse and rapidly age in appearance.
The art and science of restorative dentistry has many tools at its disposal. The priority of restoration is healing dental and oral infection. Periodontics and Endodontics and Oral Surgery are aimed at removing oral infection..
Periodontics: The bacterial origin of periodontal disease is well known, and techniques that can be applied include home care, cleanings of various types, and sometimes gum and bone grafting or surgery.
Endodontics: Infections inside the tooth are not responsive to antibiotics and can be treated with endodontics or root canal therapy. In some cases, the tooth will not respond to this so the tooth must be removed and replaced.
Prosthodontics: When replacing teeth, a prosthetic similar in size shape, color and function is made to replace the missing tooth. Items such as crowns, crowns that are linked in the form of bridges, or crowns place on implants can be utilized with the proper planning to improve and restore the entire mouth. Problems can arise when only “one tooth dentistry” is performed. Since the teeth function as a group, attention should be paid to group rather than only individual function. Replacement of missing teeth should always be considered, since gaps in the mouth can led to cavities, gum problems from bacterial build up and fractures of the remaining teeth which become overloaded.
Materials used in restorative dentistry.
The development of restorative materials is continuous with new developments constantly announced. The main materials are porcelain, composite resin, and the older far less esthetic materials including gold and mercury silver amalgam (which has been banned in European nations.)
In the modern era, composite resins are commonly used for fillings. The new resins are hidden in the tooth since they are tooth colored, and they are more conservative since they do not require removal of tooth structure to place like amalgam does.
Veneers are made to restore the color and shape of the outer surface of the tooth. They are commonly made of porcelain, which is durable and stain resistant, or of composite resin, which stains and chips and needs to be refreshed periodically. Either material is firmly bonded to the remaining tooth surface.
Crowns and Bridges
A crown is used then the tooth has been damaged by cavities or fractures and a filling will no longer last in function. A crown will reinforce the tooth during chewing by providing compressive forces rather than expansive forces to direct damaging forces to the areas the tooth is designed to resist more effectively. When a tooth is missing, two crowns can be made with a replacement tooth or pontic in between, to allow an esthetic and functional tooth replacement. The use of all porcelain crowns made of zirconia has increased in the recent past, crowding out the traditional porcelain and metal crowns in use. This newer porcelain is fracture resistant, providing a longer lasting restoration.
The advent of successful implantology has radically changed dental treatment planning. In the past heroic measures were often used to preserve teeth under any circumstances. These measures would not last exceedingly long, ending in a downward spiral of treatment, restoration and replacement with partials leading to full dentures. With the arrival of successful implants, this spiral has ceased entirely. Implants scan be placed to restore natural teeth and look and feel like natural teeth, unlike most removable dental treatments.
When implants are not feasible, for health of financial reasons, removable appliances are still available. These include partial removable dentures or full removable dentures. These need to be removed and cleaned after meals and left outside the mouth at nighttime.
This is a prosthetic device containing artificial teeth supported on a framework and attached to natural teeth with retainers. Because it is not cemented into the mouth, it can be removed or replaced in the mouth as needed. It is not worn during sleep.
There are other types of tooth restorations for partial treatment of teeth which include Inlays, and onlays. These are cemented in place for teeth that are partially defective. They can last longer than fillings but may not last as long as crowns overall.