Editorial - Saudi Dental Journal

ISSN (Print) 1013-9052
EISSN 1658-3558

The Saudi Dental Journal,
P.O. Box 52500,
Riyadh 11563,
Kingdom of Saudi Arabia

Tel.	966-1-467-7328
Fax.	933-1-467-7308 / 966-1-467-7534
Email	saudidj@ksu.edu.sa

Editorial

Towards More Conservative Dentistry

Proper diagnosis and treatment planning are man datory if we are to preserve, as much as possible, the hard and soft oral tissues in the management of dental diseases. In the early days of dentistry, the usual treatment for dental caries was extraction. Today, however, the philosophy of dental treat ment has changed. A more conservative approach is now followed in most dental specialties and this is particularly true in restorative dentistry. The implementation of caries preventive measures, such as systemic and topical fluoridation, has reduced the need for drastic restorative or endodontic procedures.
For over half a century, Black's principles of cav ity design were followed meticulously by dental practitioners. Today, some of these principles are being questioned or even avoided. This change of attitude is partly due to our greater understanding of the caries process as well as the development of modern restorative materials. For example, the advances in caries preventive measures now makes Black's principle of extension for prevention questionable, especially when tooth colored restorative materials are used.
In the area of aesthetic dentistry, efforts are made to try more conservative measures before resorting to drastic tooth reduction. Thus, attempts are made to bleach discolored teeth - a treatment proven successful in certain cases. Breakthroughs in dental materials science, the technology of tooth colored restorations and the acid-etch technique now make it possible for us to mask dark stains by ven- eering. In addition, anatomical tooth defects can now be corrected by making use of etch-retained composite resin restorations.
Endodontics has also followed the philosophy of a more conservative approach. Conventional root canal treatment is more acceptable today in the management of periapical rarefactions, and endodontic surgery is considered only as a last resort. In addition, all efforts are made to restore endodontically treated teeth so as to minimize the need for tooth extraction. In fact, treated roots are sometimes retained so as to conserve the alveolar ridge and make the work of the removable pros thodontist easier.
In harmony with more conservative dentistry, the replacement of missing teeth by using conven tional fixed prosthodontic techniques may be con sidered too radical. Therefore, the use of minimal preparation bridges, such as the Maryland bridge may be preferred in selected cases.
In periodontics, the conservative approach is recognized and there is a tendency to place more emphasis on scaling and root planning rather than on periodontal surgery.
The philosophy of more conservative dentistry permeates practically all areas of dental practice today and the trend may well continue in the years ahead.

Mohiddin R. Dimashkieh, DDS, MSc
Member,
Editorial Board