The term “restorative dentistry” is the overall term describing the repair and replacement of teeth due to any reason. The most common cause of tooth destruction for adults is dental caries or tooth decay. The major cause of tooth loss as an adult is from periodontal or gum disease, where the supporting jawbone recedes from the root and the teeth become loose and eventually lost. The major cause of tooth wear, (of which normal wear is considered to be about only 1 mm per 100 years) is from occlusal or bite issues, or jaw joint problems and the associated clenching and grinding of teeth which accelerates wear. Additionally, other damage to the teeth can come from acid erosion from the diet or GERD or eating disorders. And finally, trauma accounts for a significant loss of teeth, bike accidents, car accidents and other forms of trauma to the mouth. So anytime a dentist performs a procedure to repair or replace your teeth, that falls under the umbrella of restorative dentists, hence virtually all general dentists are “restorative dentists”. Difficult procedures that require restoration of all the teeth or the entire mouth, often require additional education and certification. It all depends on how difficult the procedure is and what the dental professional feels comfortable with. Many of the restorative procedures involve only one or several teeth. Types of procedures included in restorative dentistry include fillings, crowns, veneers, bridges, dental implants, partial or full dentures, and even orthodontics, periodontal or gum surgery, and root canal treatments. Many times multiple specialties of dentistry are involved in complex treatments for patients
Restorative dentistry used to have limited options, but with the development of better materials, digital scanning and CAD/CAM technology, 3D radiography, dental implants, 3D printing technology, today patients have a broad selection of possibilities and improved functional and esthetic outcomes. Thankfully you now have many choices in tooth-colored restorations and lifelike esthetic to help you restore the smile you’ve always had, or create the smile you never had.
Depending on the nature of your problem, your dentist can discuss your options with you, and usually these breakdown into direct or indirect restorations, and also fixed or removable restorations. Direct restorations are typically fillings, that are placed directly into your tooth at a single appointment while indirect restorations are made from a model of your tooth by a dental laboratory and returned to your dentist to be placed at a later date. That was pretty clear, but the digital revolution has changed our world and changed dentistry at the same time. Now that line is a little blurry. A crown used to be a fixed indirect restoration that was sent to a dental lab technician to create, while you wore a temporary crown for a week or so until you could return to have the permanent crown cemented onto your tooth. Now with scanning technology, at the same appointment, the dentist can scan your tooth, design a crown on CAD/CAM software while you watch, send it to a 3D mill or printer and in a few minutes your finished, permanent, tooth-colored crown is bonded to your tooth in a single appointment. Fixed restorations include fillings, crowns, veneers, bridges and dental implants and dentures that are fixed in place and stay in your mouth. Removable appliances include partial dentures supported by your teeth or dental implants, and or complete dentures also possibly supported by dental implants as well.
Restorative versus Cosmetic Procedures
There is a huge overlap between cosmetic and restorative dental procedures. If treatment is needed to repair or restore the teeth because of disease, wear or trauma, it is generally considered restorative dentistry, while cosmetic dentistry is focused on improving the esthetics of your smile. Obviously, there is a blurred line here as well as almost all restorative dentistry focuses on providing an esthetic outcome as well as a function result. Treatments and procedures that are elective and based on a person’s desire to improve their smile, self-image and quality of life are considered cosmetic dentistry. Examples of common cosmetic procedures include tooth whitening or bleaching, porcelain veneers to change the color and shape of your teeth and orthodontic braces or clear aligners to straighten and improve the position of your teeth in your smile. Like restorative dentistry, cosmetic dentistry now also has many new options based on improved materials, digital technology, and procedures that have improved esthetic outcomes.
Your dentist can discuss your many esthetic options with you, including:
- Teeth whitening or bleaching
- Composite bonding or tooth-colored fillings
- Porcelain veneers and crowns
- Porcelain bridgework
- Dental implants
- Teeth straightening or clear aligners
How can I prevent or limit the need for restorative procedures:
Top 5 dentist tips:
- A complete and thorough oral exam including periodontal probing, diagnostic testing and radiographs to get a complete understanding of your overall oral health.
- Regular ongoing preventive dental care, including cleaning and exams. Get to know and appreciate your dental hygienist! Early diagnosis leads to minimally invasive care or intervention.
- CRM, or caries risk management is the new best practice or standard of care. Instead of identifying cavities, your dental health professional determines the cause of your cavities and helps you focus on eliminating the cause.
- Good daily homecare hygiene habits. Nothing replaces effective brushing and flossing habits. Bleeding gums are a sign of gum disease and may put you at greater risk for a heart attack or stroke.
- An effective diet. You are what you eat, let your medicine be your food. Identify healthy meal habits and be aware of the hidden sugars and ultra-processed foods.