Dentistry has come a long way from the dark ages of receiving dental care before the use of local anaesthetic (ouch), to the remarkable discoveries made by our very own Greene Vardiman Black, a pioneer in dental science and all things tooth-related. Many of us remember having those silver amalgam fillings some time ago, an extraordinary material that allowed us to restore and maintain our dentition. However, with time, dentistry has evolved with a shift towards preventive dentistry. Preventive care in modern dentistry focuses on the significance of patient risk and early disease management¹. It is a form of dental care that allows us to take control and ownership of our oral health, well before disease strikes. Preventive dentistry and minimally invasive dentistry , takes many forms². Methods of disease prevention may vary and should be tailored to each individual, depending on their specific needs assessment and stage of life. Personal dental needs will evolve from childhood to adolescence and well into adulthood; as we age and transform, so do our mouth, gums and teeth.
It is important to understand what preventive oral health measures may look like in and out of the dental care setting. It is often assumed by our patients that brushing twice a day with a standard fluoridated toothpaste is the pinnacle of preventing any signs of tooth decay or gum disease. However, there is much more to it. Planning a personalised and holistic preventive strategy is based on a thorough risk assessment to determine risk category, and requires initiative from the dental practitioner, the patient, and often the patient's family. This might include determining the patient’s fluoride use, oral hygiene regime, diet, medical history and regularity of dental attendance. Once a risk category is determined, we can pinpoint areas for improvement to help reduce the disease risk of our patients, using the preventative approach. .
The Preventive Approach
Minimally invasive dentistry is a therapeutic approach that aims to reduce an individual’s risk of developing oral disease, and treat early disease with the aim of preserving as much of the natural tooth structure as possible. There are many avenues within this approach, and what is best for your patient will be influenced by your patient’s local, genetic and systemic factors. However, a general approach may include:
Regular Dental Check-ups: Dependent on a patient’s risk category, attending dental exams every three to twelve months helps maintain and review the patient’s oral health. This includes evaluating past dental treatments, ongoing care, and planning for future dental needs.
Radiographs: Radiographs aid in detecting early signs of periodontal disease, tooth decay, and potential oral pathology that may require further evaluation.
Risk Assessment: Based on individual factors, risk assessment enables the patient and clinician to work together in preventing disease, from low-risk to high-risk.
Oral Hygiene Education: A crucial strategy in preventing plaque buildup, tooth decay and gum disease.
Dietary Advice and Education: Diet plays a vital role in oral disease development, so understanding a patient's eating habits is essential.
Fluoride Use: Includes fluoride from water consumption, high fluoride toothpastes and mouth rinses, at home dental products, and professional applications.
Professional Fluoride Application: High-strength fluoride treatments are offered to individuals at an elevated risk of tooth decay, particularly when active demineralisation is observed.
Scale and Polishing: A preventive procedure that reduces plaque buildup and lowers the risk of periodontal disease.
Fissure Sealants: A minimally invasive procedure that protects teeth, particularly for those with anatomical features that increase the risk of decay.
Why bother?
Whilst it may seem overwhelming, preventive dentistry is accomplished with just a few simple steps, relying on collaborative effort between the patient and their clinician. Minimally invasive dentistry yields impressive results in preventing oral disease and identifying patient needs early. With the guidance of a dental professional, patients and their families can gain a better understanding of their oral health and take better control of it throughout their lives. Proactive oral health prevention helps avoid the need for invasive dental treatments, which, for many patients and providers, are not the preferred option. So, what steps will you take to prioritise preventive oral health care?
References
Frame, PS, Sawai, R, Bowen, WH & Meyerowitz, C, 2011, ‘Preventive dentistry: practitioners’ recommendations for low-risk patients compared with scientific evidence and practice guidelines’, American Journal of Preventive Medicine, vol. 18, issue. 2, pp.159-162.
Pitts, N, 2011, ‘Preventive and minimal intervention dentistry in the undergraduate curriculum’, Journal of Dentistry, vol. 39, supp. 2, pp. S41-S48.