The Changing Face of Dentistry22 February 2018 Categories: Dentistry
By Dr. Antony Bellaries
This time of year often provides a period of reflection and an optimistic look to the future. This year it is the 70th anniversary of the inception of the National Health Service, formed as part of Clement Attlee’s (then Labour Prime Minister) “cradle to grave” welfare state reform policy in the aftermath of the Second World War. The NHS was the first universal health care system established anywhere in the world. Amongst other services, it provided greater access to dental care, in an otherwise dentally neglected population.
In the mid half of the twentieth century, dental disease was rife. The vast majority of dental treatment provided was tooth extractions and the provision of dentures. So what’s changed? A huge amount! Below I’ve listed my top four significant changes to happen to dentistry over the last seventy years:
In the 1900s, prominent American dentists G.V. Black and Mckay investigated the effects of fluoride on teeth, however it wasn’t until the 1950s that it was scientifically proven that fluoride helps reduce tooth decay. The ‘Grand Rapids’ study involved adding fluoride to the water supply of a small Michigan town. The results were astonishing, reducing the decay rate in children by up to 60%.
As a result, Proctor and Gamble introduced fluoride toothpaste in the late 1950s and now almost every toothpaste on the market contains fluoride. Compared to the early half of the twentieth century, Fluoride has helped change dentistry into a prevention-orientated profession and surely must be the most significant advancement over the last seventy years.
Prior to the widespread use of dental implants, if a tooth was lost then most people either accepted the gap or had it replaced with a removable denture or a fixed bridge.
In the 1950s, Swedish physician Professor Branemark discovered the bone bonding properties of titanium and developed the first dental implants. Since the late 1990s there has been a huge increase in the provision of dental implants, which provide a predictable, conservative fixed solution for a missing tooth or teeth.
Implants are artificial roots that are gently placed into the jawbone where the tooth once was. As they are made of titanium, the implant not only has the ability to fuse to the bone, it is also bio compatible, which means that it will not be rejected by the body. Dental implants not only help create a beautiful smile, but most importantly, they help give patients a more secure bite and the ability to rediscover all of their favourite foods. Without question, dental implants are the gold standard in dentistry for replacing missing teeth, but they can also be used successfully to secure loose dentures and have literally changed patients lives.
Dental Hygienists and Dental Therapists
Periodontal (gum) disease is the biggest cause of tooth loss in the UK. It is a plaque related, chronic inflammatory condition of the structures surrounding a tooth. If left untreated, gum disease can lead to the teeth becoming loose and eventually falling out or having to be removed. It is often symptomless and as a result can go unnoticed for many years.
In the 1950s, dentistry was very much a “drill and fill” culture, rather than the preventative practice we see today. Dental hygienists and therapists now work in tandem with dentists to help prevent and treat periodontal disease and tooth decay. As a result, they have made a huge difference to the dental health of the population over the last forty years.
Minimally Invasive Dentistry
Back in the 1950s, “extension for prevention” often resulted in teeth being removed unnecessarily to create room for the restoration of a tooth. Up until recently, cosmetic treatments also involved aggressively shaving down the healthy tooth to prepare it for lab made restorations such as crowns or veneers.
At The Raglan Suite we are dentists first and foremost and although we want people to be happy with their smile, primarily we want the teeth to be healthy and remain healthy long-term. Modern, ‘minimally invasive’ dentistry focuses on preserving as much of the tooth structure as possible – i.e. the teeth and supporting tissue, through more conservative treatment options. By preserving and restoring healthy tooth structure (and ideally not affecting it all), any risk associated with treatment is dramatically reduced.
There are now exceptionally aesthetic ‘direct composite’ restorations that bond directly to the teeth, without the need for extensive tooth reduction.
The next seventy years?
Without a doubt, dentistry has changed beyond recognition over the last seventy years, but what does the future hold?
A big change that is already happening within dentistry is the impact of the digital age. Most dental laboratories and some dental practices have already embraced digital technology. Our on-site laboratory uses digital CAD/CAM technology to help design and construct our dental restorations. Laser printing and computer led milling is already here and will develop further in the future. Some practices, including The Raglan Suite, have replaced the uncomfortable mouthful of impression putty with state of the art, intra-oral digital scanners – a move which is greeted by huge relief from most patients.
It’s also entirely possible that at some stage in the future robots may be able to perform dental procedures on patients more accurately and at a significantly lower cost than a dentist. I will leave you with that scary thought!
Dr. Antony Bellaries BDS MFDS RCS (Ed) has practiced and studied extensively in the field of Endodontics (Root Canal Therapy) for over 20 years and is an active member of the British Endodontic Society.