With the new technology we’ve acquired at the practice in the last 12 months, I’ve taken more time to consider what the philosophy and goals of the practice should be. This is a work in progress, but I’m trying to articulate my position on several key dental fields.
Restorations
Many of our patients have grown up in an age of amalgam and dentures, and in many cases have several layers of restorations requiring increasing maintenance with time. In the past, I’ve found myself settling on patching many of these as the wear and break down, with the mindset that I was taking the conservative approach, and keeping a patient happy by taking the easiest path.
But I’ve been a dentist for almost 15 years now, and so I can see now see more clearly where that path leads. The tooth is getting weaker over time, and there will be increasing frustration with return visits for more repairs, annoyances as more layers and difficult contouring lead to food packing and gum problems, and eventually more significant damage that results in either complicated treatment or extraction. And we have many teeth in our mouth that can fail, which means compounding problems, and eventually a treatment plan that can be overwhelming.
But dentistry has progressed rapidly in recent years, both in what can be done digitally, but also our means of preserving the amazing biological properties or enamel and dentine, even when there has been significant breakdown of those structures. Adhesive bonding to teeth has become predictable and durable, and the array of materials that can be used to rebuild or recontour lost tooth structure have incredible strength and aesthetics.
We now have a spectrum of options for any tooth requiring restoration. Direct resin composites are still an effective tool for restoring small cavities casued by decay, or highly aesthetic repairs when trauma has damaged the edges of a front tooth. And we can still cover an entire tooth with a crown if the need is there. But in between those extremes, we’ve made significant advances in the fabrication of inlay and onlays with ceramics designed on computer and milled outside of the mouth, before being cemented into place. These treatments can make it so that a tooth with a long history of gradual decline, becomes less fragile and less of a maintenance burden. If we tackle these issues as they arise, we can try and keep treatment plans manageable.
So there is still a place for minor patches and repairs, but I am endevouring to provide clearer proposals and plans for the proper fix. It’s the right tools and the right materials that are the biggest factor that I can personally control in the longevity of my dental work, and I owe it to all my patients to at least convey what those are.
Cosmetic dentistry
I’ll keep this short for now, but cosmetic treatments are an important and exciting part of dentistry. While I don’t wish to market my practice as a “Cosmetic Dentist”, I (like all dentists) wish for my work to look as good as possible. So the key thing for me at Sorrento Dental is to be able to set realistic expectations prior to commencing any work. Wherever possible, this means using trials and guides to give a very clear understanding of the outcome early on, to eliminate surprises. I believe that digital dentistry gives me far more control over this process, and gives me much more confidence that we can achieve an amazing result. I am actively looking for more cases where patients would like to improve the appearance of their teeth, as these transformations can be some of the most satisfying things we can do as dentists.
-Dr Reece Orbuck