Tooth preservation is the central focus of both preventive and therapeutic dentistry. The various methods used in tooth preservation treatments are correspondingly diverse. A distinction can be made between methods used preventively and those used when the teeth or periodontium are diseased. Tooth preservation thus begins at a relatively young age and not only in later life, when the integrity of the dentition is acutely at risk.
Below you will find further information as well as dentists who specialize in tooth preservation.
Definition: What is tooth preservation?
Tooth preservation is one of the key areas of modern dentistry. In many cases, dental treatments are not only aimed at relieving symptoms. An important goal of many procedures is also to preserve existing tooth structure for as long as possible.
Tooth preservation methods are used for both preventive and therapeutic purposes:
- Preventive means that serious dental problems are avoided in the first place through prophylactic measures.
- Therapeutic means preserving a diseased tooth as much as possible instead of extracting it.
Ideally, the development of diseases of the teeth and periodontium is prevented, so that therapeutic intervention is not necessary later on.
So-called conservative dentistry is dedicated to tooth preservation. It primarily addresses plaque-related dental diseases as well as carious and non-carious damage. These conditions pose the greatest threat to tooth preservation.
This area of dentistry therefore includes
- dental prophylaxis,
- caries treatment,
- periodontology (treatment of bacterial diseases of the periodontium), and
- endodontics (treatment of other inflammatory diseases of the periodontium and dental pulp).
Almost everyone in Western Europe comes into contact with this broad field of dental preservation medicine at some point in their lives. Dental prophylaxis begins in childhood and, in Germany, includes two annual checkups.
Regular checkups at the dentist are an important part of dental preservation © Andriy Bezuglov | AdobeStock
Reasons for Treatment: When Is Conservative Dental Therapy Necessary?
The most common reason for tooth preservation treatment is dental caries. Caries affects more than 98 percent of people living in Western Europe. Tooth decay is a disease of the tooth structure caused by bacteria found in the biofilm surrounding the teeth. These bacteria metabolize sugar molecules into acids, which in turn attack the tooth structure. Over time, this leads to cavities in the enamel.
Another common reason for tooth-preserving treatment is periodontitis. This is a bacterial disease that leads to the breakdown of the bone and gum tissue that support the teeth. Warning signs include the formation of dental plaque and inflammation of the gums, some of which can also develop into periodontitis. These two conditions are therefore also frequent reasons for tooth-preservation treatments.
Other reasons for tooth-preservation therapies include
- inflammation of the dental pulp, which can be caused by bacteria as well as by mechanical, chemical, or thermal irritation, and
- damage to the tooth caused by other environmental factors.
Tooth Preservation Methods: How Does the Treatment Work?
The methods of tooth preservation vary just as widely as the reasons for treatment. Here, too, a basic distinction is made between preventive and therapeutic approaches.
Prevention relies primarily on the individual: effective oral hygiene is the best way to prevent tooth damage. Dentists teach their patients effective toothbrushing techniques. Professional dental cleanings can also help minimize risk factors.
Therapeutic approaches require an even greater degree of differentiation. The best-known method is filling therapy, which is used to remove carious lesions. The lesion is removed using a drill, which creates a hole in the tooth structure. This hole is then filled with filling material so that the tooth can bear a full load. This also prevents bacteria from penetrating the interior of the tooth.
In the past, amalgam was typically used as the filling material. Today, dentists are increasingly turning to ceramics and composite resins.
For early-stage tooth decay in certain areas of the tooth, a new type of treatment that does not require drilling can also be used. In this procedure, a resin infiltrates the lesion and seals it.
For periodontitis, a multi-step treatment approach is often recommended. After removing visible plaque, the inflamed gum pockets, including the tooth root, are curetted: the inflamed tissue is scraped away. In some cases, antibiotics are also used to reduce bacterial colonization.
If the dental pulp is inflamed, root canal treatment is necessary. In this procedure, the root canal is opened to remove the inflamed tissue. The canal is then sealed with a filling material.
In addition to the methods described, other techniques are used in oral surgery. Surgical dental treatment is primarily required following accidents and other traumatic damage to the teeth. These procedures also serve to preserve teeth but are not considered part of conservative dentistry.
Aftercare: What Should You Keep in Mind After Treatment?
Aftercare depends largely on the type of treatment. In any case, however, it is important to understand the basics of oral hygiene and to continue practicing them after treatment. This helps prevent further diseases of the teeth and periodontium.
This includes, for example, regular and effective tooth brushing as well as the use of antimicrobial mouthwashes. In some cases, dietary changes toward a diet lower in sugar are also advisable and are recommended by dentists.
There is no general answer to whether it is necessary to take special care of the affected tooth after treatment.
After cement fillings, for example, it is necessary to avoid using the tooth for chewing for at least one day and to clean it very gently, as the filling must first harden. This does not apply to ceramic or composite fillings, however.
In general, it is recommended to avoid eating anything immediately after local anesthesia until sensation has fully returned. Otherwise, injuries—such as biting the tongue or cheek without realizing it—are possible.
What happens after tooth-preservation treatment?
Complications can arise with any therapeutic procedure aimed at preserving a tooth. For example, there is a risk of unintentionally damaging healthy tooth structure during treatment. It is also possible for bacteria to enter the interior of the tooth and the root canal during certain treatments. However, these risks are minimized by the dentist’s professional approach.
The prognosis for conditions that threaten tooth structure depends primarily
- on the timing of the start of treatment as well as
- on follow-up care
. The sooner treatment is initiated, the more likely it is that tooth loss can be prevented. For this reason, it is advisable to take advantage of the preventive dental checkups covered by statutory health insurance plans.
Periodontitis is a special case: The damage to the periodontal tissues that has occurred usually cannot be reversed, or can only be reversed to a limited extent. It is therefore particularly important to begin appropriate treatment in a timely manner.
