Preventive (evidence-based) approach to quality general dental care.

Restorative and scaling treatments have not generally provided an effective method for managing dental caries and periodontal diseases. Rather, restorative treatment has often covered up the disease processes in the short term and created a new problem: that of maintenance and re-restoration of restored teeth. Thus, standard invasive dental treatments that are commonly provided fail to address the fundamental bacterial nature of the diseases. Indeed, these treatments rather readily generate and perpetuate a totally unacceptable chain of events. This chain embraces many shortcomings, which themselves nurture what may be described as the repeat restorative cycle. The time has come to correct this iniquity. Dental caries and periodontal diseases are dynamic conditions which need 'managing' with a focused cocktail of preventive and refined restoration care. Much more emphasis should be placed upon the assessment of each and every caries or periodontal lesion, with a view to implementing specific preventive measures and allowing the natural arrest of disease processes to occur. The universal adoption of a preventive (evidence-based) approach to making dental treatment decisions could be by far the most powerful factor in reducing the restorative burden of dental services. It is clear that dental education and practice need to rise proactively to the challenge, or changes will be forced upon them while they are in a defensive position. There is a need to move wholeheartedly and contentedly into the preventive era. Copyright 2003 S. Karger AG, Basel