Composites: A Technique Sensitive Procedure

Hello!

My team and I went to a dental seminar this past Friday and I wanted to share a few of the things we learned with all of you!

One of the interesting things we heard was that people are living longer. In the early 1900s men were only living an average of 45-50 years, and women 50-55 years. Back then, it didn't matter as much that dental restorations lasted only a short time. Now, a hundred years later in the 2000s, men and women are living well into their 80s and 90s, so our approach to dentistry has changed dramatically and we want our restorations to be lasting a long time.

There is only so many times you can drill on a tooth before the tooth is compromised. With that statement in mind, we want to be as minimally invasive as possible to preserve as much natural tooth structure so that the tooth will last a long time. Interestingly though, on average, composite restorations only last about 5 years, and bridges only 8 years! There is something very wrong with those numbers. Lets say at 25 you get a 2-3 surface filling and by 30, that filling has failed and you are now treatment planned for a 3-4 surface onlay. Now lets say that onlay lasts about 15 years and you are now 45, but the onlay needs to be replaced by a build up and a crown. On average crowns can last 15-20 years so at best that crown lasts until you are 65. But now what? Did that tooth reach its 85th birthday? Doesn't look like it.

Composites are technique sensitive, they require a lot more attention to detail and a lot more time than you might imagine. The bonding process is extremely critical, as well as the type of curing light and filling materials used. If a tooth's first dental treatment is a filling, we want that filling to last much more than 5 years. A composite can potentially last a patient 15+ years if it is done right! That's a huge difference.

Every time you get dental work done, the hole gets bigger and bigger and more tooth structure needs to be drilled away. The last steps at saving a tooth include crowns and root canals. Once those have failed, the tooth often needs to be extracted. But with each of these steps from composites all the way to crowns and root canals, you can prolong the life of your restorations by good homecare and regular visits to the dentist. And if the work is done right the first time, you will get the maximum longevity and lifespan out of your dental restorations. Many of our patients have followed this approach and have their teeth well into their 80s and 90s. When patients lose teeth and must go to dentures, they lose about 80% of their ability to chew food, so the quality of life can go down.

Much of the seminar was a refresher for my team and I, as I have been practicing these techniques for some time now. As always though there were a few new things we will be implementing into our composite routine so that our patients are getting a lot of life out of their composites and that their own teeth get to reach their 85th birthdays! And as always, I want to preserve as much natural tooth structure as possible and use a minimally invasive approach to all aspects of dentistry in my practice.

Be well,
Richard Stickney DDS PS

Bana Testing, What Is It?

BANA Testing

Good afternoon all!

This week's blog post is going to be about a new test we are doing in the office that will help us with periodontal cases. It's called a BANA test.

What is a BANA test?

The BANA test is a quick test that helps us determine whether a patient has any or all of the three most common and riskiest pathogenic bacteria called "red complex bacteria", Treponema denticola, Porphyromonas gingivalis and Bacteroides forsythias. These three bacteria are directly associated with periodontal disease in adults. The test is as sensitive as expensive DNA tests, though despite its accuracy it is also amazingly simple to use.

How does it work?

All this test requires is a very small sample of plaque from a pocket. We lightly smear this sample onto a small test strip that has a specific enzyme on it that reacts with red complex bacteria. We then put this test strip into an incubator for 5 minutes (yes only 5 minutes!) and when it comes out, if any of the 3 bacteria are present, the sample will have changed to a blue color. This test is easy, fast and inexpensive to do!

We are always looking for ways to better help and treat our patients. With some of these new tests we are able to better know how to treat periodontal disease and get our patients back to optimal health! If you have any further questions, please feel free to ask!

Be well.
Richard Stickney DDS PS