Optimization of Treatment
Bernard Touati, DDS, MS
The field of dentistry has recently become characterized by a growing trend toward specialization that is evident in research journals and practices themselves. It is difficult to remain proficient in the growing restorative armamentarium, and the danger of this trend is that patients may not be aware of or have access to the optimal form of treatment as a clinician's expertise is increasingly limited. While each manifestation of a clinical condition can have only one correct diagnosis, it is generally possible to treat the patient with several different options - each of which must be analyzed to determine potential advantages and limitations with regard to the specific profile of each patient.
Contemporary clinical literature is valuable for clinicians through its presentation of the most up-to-date information on material and technical innovations. This broadens the scope of the treatment options provided by dental professionals and increases their capacity to address limitations that present clinically. This increased versatility allows clinicians to more effectively describe the appropriate treatment to their patients and refer them to colleagues who specialize in any necessary adjunct therapy (ie, periodontics, orthodontics, reconstructive techniques). In this manner, treatment is not only efficient, but also ethical, as qualified dental professionals strive to conservatively deliver care that satisfies mandatory restorative criteria (ie, function, biocompatibility, and aesthetics) while preventing excessive tissue mutilation.
Of course, if the ideal treatment was also regenerative, it would be a panacea. Implant treatment, in addition to providing a predictable, stable, restorative solution, may be the best way to prevent the loss of hard and soft tissue in an edentulous site. If the patient is instructed on the extended duration and expenses involved in such treatment, however, he or she may elect to be treated with conventional fixed partial dentures. The necessary reduction of sound tooth structure involved with such a procedure may be more radical in the clinician's estimation, but the patient must be allowed to make this decision. As the Talmud states: "We don't see things as they are; we see things as we are," thus the prudent clinician must be careful not to impose one treatment on a patient. It is primarily through continuing education that dental professionals remain knowledgeable of these various treatment options.
*Editor-in-Chief, Practical Procedures & Aesthetic Dentistry and private practice, Paris, France.