What is ‘Reconstructive Dentistry’?28 March 2017 Categories: Uncategorized
By Dr. Steve Byfield
BDS(lond) MFGDP RCS (UK)
Reconstructive Dentistry is the term used for the treatment of patients who have experienced advanced dental disease.
Symptoms range from loose, missing or decayed teeth, increasing tooth spacing (especially in the front of the mouth), to very worn teeth and the inability to chew food properly. Reconstructive Dentistry is the treatment used to return the patient back to dental heath and restore tooth function and aesthetics.
Due to the complexity of reconstructive dentistry, it normally involves what is called a “multidisciplinary approach”. This means that a team of highly skilled clinicians, who work exclusively within their chosen field of practice, are brought together to provide treatment and ultimately the best clinical result for the patient.
What to expect from the reconstructive dentistry process
Treatment of advanced cases is rather like a staircase – patients start at the bottom step and progress through treatment one a step at a time:
Step One: Examination & Diagnosis
The first step is to receive a full dental examination. This may be carried out over one or more visits with the lead clinician who may bring in other clinicians in their respected fields to provide their opinion.
Each patient is also assigned a dedicated treatment co-ordinator to support them throughout their journey with us. The treatment co-ordinator provides a direct point of contact and administrative liaison from diagnosis though to completion.
Step Two: Stabilisation
Once a diagnosis is made and the patient has a full understanding of what the issues are, we move onto the next step – ‘stabilisation’. This stage is essential to restore the patient’s mouth to a healthy and stable state. It involves the removal of any dental disease and the restoration of tooth and gum function and aesthetics. This could feature a range of treatments including gum therapy, tooth extractions, root fillings, provisional bridges or dentures, or cosmetic veneers.
Step Three: Reassessment and Advanced Treatment Planning
Just like assessing a failing wall, at times it’s obvious it has to come down and be rebuilt, but other times all that is required is re-pointing. Some of the time underpinning is considered to avoid removing the wall, however, the long-term success may then be unknown. Advanced treatment is similar because as clinicians we do not want to over treat – i.e. carry out unnecessary, aggressive treatment – nor under treat and thereby not achieve a long-term result.
At the reassessment stage, the team of clinicians will closely examine the situation after stabilization and from there develop a plan for the next step – advanced restorative treatment. The patient will then have the opportunity to consider their options. If they would prefer to spread the financial investment or the amount of active treatment, advanced care can normally be carried out in phased appointments. However, some patients prefer to address all advanced treatment at the same time. The decision is always down to personal choice.
Step Four: Advanced Care Appointment/s
The Raglan Suite philosophy is to provide the highest level of treatment with the least intervention to meet the patient’s expectations. Wherever we can, we prefer to keep the natural teeth and avoid invasive, irreversible tooth loss with aggressive crowns. Within advanced care, we will normally replace teeth with implants or dentures to avoid bridges that are very destructive.
If aesthetic treatment is required, we prefer teeth whitening and direct composite veneers that need little or no preparation of the tooth. Any invasive preparation has a high risk of damaging the nerves and weakening the teeth. Although we want people to be happy with their smile, our priority as dentists is for teeth to be healthy and remain healthy long-term.
During the advanced restorative stage we may recommend that patients undergo a period of ‘provisionalisation’. This is where the “final” treatment is actually provisional, in order to re-evaluate the patients aesthetics, function and feel of the new teeth.
Step Five: Final Restoration
Once both the clinicians and patient are happy, then the final restorations are placed that mirror the approved provisional stage.
Step Six: Maintenance
The last step to the top of the staircase is high level maintenance of the patient’s reconstruction. At The Raglan Suite we have an experienced team that show patients how to look after their new smile and, in conjunction with daily home care, will help ensure that your mouth remains healthy and stable long term.
The long term
We are frequently asked, “will advanced treatment last me a lifetime?” The true answer is that it depends on a number of factors – your age at the time of treatment, how well you look after your mouth on a daily basis, the execution and planning of the treatment – and I have to say – also a little luck in your gene make up.
Natural teeth in general do not always last a lifetime. So if we consider that any form of Dental treatment is second best to natural teeth, then it is likely that there will be a form of re-treatment required at some point, albeit localised. It is important that patients understand this possibility before consenting to advanced therapy.
As a dental surgeon, seeing the huge difference that reconstructive dentistry can make to a patient’s life is what makes me get out of bed in the morning. I see patients who are withdrawn and self-conscious, grow into smiling, happy, confident people, who boldly hold their heads up in the world around them. To be part of that incredible journey is very satisfying for all concerned – myself, the team here at The Raglan Suite and of course, the patient.
Dr SDE Byfield
Dr Steve Byfield has over twenty years experience in implant and restorative dentistry. Our clinicians are dedicated to finding the best solution for you and are always happy to answer any questions you may have in relation to restorative dentistry. Call 01423 565432 to book your complimentary consultation or contact us through our online enquiry form.