CONSERVATIVE DENTISTRY

%nameConservative treatments – what is it?

The primary goal of the dentist is to keep the patient as many of theirs’ own teeth as possible. Treatment and restoration of teeth damaged by caries or other factors are procedures generally referred to as preventive treatments. Nowadays, the emphasis is placed on the minimally invasive development of destructively damaged tissues in order to preserve the best strength of a “repaired” tooth. It can be made thanks to advanced materials used to fill the defects, which bind permanently with the tooth because of physical phenomena and chemical reactions occurring at the place of their joining.

Conservative treatments – types of treatments

Caries is the most common disease that affects our teeth, caused by bacteria that secrete substances that dissolve hard tissues. This leads to the destruction of the crown, and sometimes even the root of the tooth. Treatment includes removing the infected part and then rebuilding it with materials that color, structure and strength mimic the natural tooth. Today we can find unusual diversity of materials used in conservative dentistry. In the anterior teeth, where high aesthetics are required, we use the technique of combining different shades to achieve a perfect look, while in the lateral teeth the most important are strength and resistance to forces acting, for example, during eating. The constant development of dental materials allows us to meet even the highest expectations of the patient.

Sometimes, caries causes infection of the tooth root. There are canals there, in them nerves and blood vessels, which is the cause of pain. In this case, endodontic treatment should be performed: removal of damaged tissue from the canals and filling them with substitute material (see: endodontics).

Teeth can be also damaged by other factors. They can get worn as a result of improper brushing or chipped due to excessive clamping or grinding. This results in cavities that also need to be cleaned and filled. Leaving them as they are not only weakens the entire structure, leading to even more damage, but also can be an additional place for the development of caries.

Conservative treatments – the course of the procedure

stomatologia zachowawcza wroclawEach treatment in this field begins with local anesthesia, which provides comfort to the patient, eliminating pain during the entire procedure. The next stage is installation of a cofferdam, which enables the precise and predictable work of the doctor. It is a rubber insulating the treated tooth from the environment, thanks to which the procedure is complete aseptic. Isolation from saliva is very important because almost all materials used in conservative treatment require complete dryness during their insertion into the cavity. The cofferdam has many advantages also for the patient – it solves a problem of excess water in the mouth (used for cooling during development) and eliminates a risk of accidental falling of tools or materials into the mouth or throat.

Actually, after anesthesia and inserting the cofferdam, the patient can completely relax, because then the doctor painlessly and thoroughly cleanses the tooth, and rebuilds it with material imitating natural tissues. Finally, the doctor adjusts the filling for proper contact with other teeth, and the patient can evaluate the final result.

In the case of need for endodontic treatment, the procedure is also performed under anesthesia and with a cofferdam cover, including removal of bacterial infected tissues from the tooth canals with the use of machine tools, thorough rinsing with disinfectants and then tight filling (see: endodontics). Of course, the final element is the restoration of the tooth crown in the manner described above.

Conservative treatments – indications and contraindications

We can treat this way almost all teeth with carious lesions, except for cases with the loss of a significant part of the tooth crown, where prosthetic treatment is more desirable. This way you can also cure cavities of non-caries origin, which are the result of clashing or breaking off fragments of hard tissues. Separate indications are teeth incorrectly shaped or discolored due to genetic diseases or food deficiencies. Preventive treatment is also used as a method of repair, when caries develops under the filling performed many years before or the inflammation process in the tooth canals resumes.

If the patient neglects regular visits to the dentist or ignores pain symptoms, it may happen that the teeth are too damaged to be treated conservatively, because the material will not have anything to hold on to. Extensive inflammatory changes in the bone surrounding the tooth or significant tooth dislocations are further contraindications to preventive methods. The final decision on the treatment method is always made by the dentist based on detailed diagnostics.

Conservative dentistry – frequently asked questions

Is the treatment painful?

In our clinic, preventive treatment is always preceded by local anesthesia (with the exception of individual contraindications related to the patient’s health condition), which ensures complete pain-freeness and comfort of the patient during the entire procedure.

How long does the treatment last?

Usually treatments in the field of conservative dentistry are not time-consuming and take no more than an hour. However, each patient is different and sometimes the doctor has to spend more time wanting to adapt to individual occlusal conditions or maintain perfect aesthetics, for the benefit of the patient, of course. In addition, often the final image of carious lesion is obtained only after opening the cavity, which may have looked small from the outside and turns out to be deep, sometimes requiring endodontic treatment.

What are the recommendations after the procedure?

The most common recommendation after conservative treatment is to avoid eating and drinking for 1-2 hours after the treatment to allow the used material to permanently and tightly bind to the tooth. During this short time after leaving the clinic, chemical reactions in the tooth still take place, and are crucial for excellent strength of repaired tooth. You can return to a normal lifestyle later. Of course, if filling in some way hampers, for example, when eating or crimping your teeth, and when there is pain when you bite, you should immediately report to the dentist to correct the filling.