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More comfortable treatment, better outcomes

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In the last 20 years, oral health treatment has undergone a revolution – in fact, if dental procedures make you anxious, it’s probably because you haven’t had one in a while.

The list of research-driven advancements that have dramatically improved treatment comfort for patients in recent decades is long, but among the most significant are dental implants, says Dr. Christopher Lee, a dentist and researcher at Dalhousie University in Halifax. Not long ago, dentures were the only option if a tooth was lost; today, implants are commonplace and the procedures have a success rate of about 98 per cent.

 During the same period, digital X-rays significantly reduced radiation exposure while improving diagnosis. Dr. Lee adds that while the term “root canal” recently struck fear “in the hearts of even the strongest person,” improved equipment means that the procedures now don’t feel much different to the patient than having a filling done.

The potential effectiveness of white filling materials has also improved dramatically. “We’ve found that the material needs to be cured much longer [than was originally thought] in order to last and do its job,” Dr. Lee explains. “A machine invented here at Dalhousie by Dr. Richard Price, the MARC, now teaches dentists to use a curing light properly, which makes the fillings last a lot longer with fewer complications.”

Other research under way promises to do away with the “goopy moulds” now used to make crowns, denture and bite guards, adds Dr. Lee. “We’re close to the point where scanning technology results will be just as good.”

Microbiologist Dr. Song Lee, also a researcher at Dalhousie, is leading a team at work on a vaccine for the bacteria that cause cavities.

In the field of endodontics, the use of microscopes during treatment has led to improvements in precision and expanded the range of cases that can be treated. More recently, new engine-driven instruments have made endodontic treatment much easier.

“For the patient, it means that challenging anatomic configurations are better managed, with less compromise,” says Dr. Shimon Friedman, award-winning director of the Graduate Endodontics Program at the University of Toronto’s renowned faculty of dentistry. “The treatment procedures require less time and altogether less struggle. You don’t have to open your mouth like a hippopotamus, and we’re able to do a better job at disinfecting the root canals.”

 He expects the next advance in treatment to come at the annual session of the American Association of Endodontists in late April, with the introduction of new technologies that may allow endodontists to disinfect the root canal with much less removal of tooth structure, making it possible for the tooth to function for a longer time.

Across the oral health care sector, scientific confirmation of the links between oral health and overall health has expanded the role of dental professionals, says dental educator Jo-Anne Jones.

 Ms. Jones says that evidence linking periodontal diseases to increased risk of diabetes, cardiovascular disease and some autoimmune disorders has led dental professionals to become better patient educators and to master the early detection of disease. “Dentistry has become much more proactive, with a focus on risk assessment and management in the three key areas of decay, periodontal diseases and oral cancer,” she explains.

 These trends have spurred development of new tools for prevention, diagnosis and treatment, she adds. “We have screening tools to identify the very earliest stage of de-mineralization – the breakdown in tooth enamel. We’ve also made huge advances in the early discovery of oral lesions and other abnormal changes that can signal oral cancer – with technology that allows detection of abnormalities beneath the surface, before they become visible.”

 Similarly significant advancements have also occurred in oral home care, says Ms. Jones, who was a practicing dental hygienist for 35 years before becoming a health writer and educator. “For example, there are now power toothbrushes with dynamic sonic fluid action that removes more – and cleaning tools that are an effective, effortless alternative to floss.”

 

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“Dentistry has become much more proactive, with a focus on risk assessment and management in the three key areas of decay, periodontal diseases and oral cancer.”

 Jo-Anne Jones is a dental educator