Operative dentistry is the art and diagnosis, treatment, and prognosis of defects of teeth which do not require full coverage restorations for correction; such treatment should result in the restoration of proper tooth form, function, and esthetics while maintaining the physiologic integrity of the teeth in harmonious relationship with the adjacent hard and soft tissues; all of which enhance the general health and welfare of the patient.
Functions and Purposes of Operative Dentistry
Functions and purposes of operative dentistry are actually derived from definition itself:
- Diagnosis: Proper diagnosis of lesions is vital for treatment planning of restoration of tooth.
- Prevention: Ultimate goal should be disease prevention.
- Interception: Preventing further loss of tooth structure by way of restoration.
- Preservation: Conservative approach while tooth preparation is necessary to preserve as much of tooth structure as possible.
- Restoration: Ultimate goal of operative dentistry is restoration of health, this includes restoring form, function, phonetics, esthetics and occlusal stability and also surrounding tissues and entire stomatognathic systems.
- Historically operative dentistry was considered to be the entirety of the clinical practice of dentistry, today many of the aspects of operative dentistry has become specialty areas.
- In early days dentistry was practiced by so-called ‘barber dentists’.
- It was during late 18th century that GV Black who had both medical and dental degrees who modernized dentistry and he is rightly called as Father of Modern Dentistry.
- First dental college established was Baltimore College of Dental Surgery in 1840.
Factors Affecting Operative Treatment
Indications for operative procedures are numerous.
They can be categorized into three primary treatment needs:
- Malformed, discolored, fractured teeth.
- Restoration replacement or repair.
- An understanding of and appreciation for infection control to safeguard both health service personnel and patients.
- A thorough examination of not only the affected tooth but also the oral and systemic health of the patient.
- A diagnosis of the dental problem that recognizes the interaction of the affected area with other body tissues.
- An understanding of the material to be used to restore the affected area to a state of health and function, including a realization of both the material's limitations and techniques involved in using it.
- An understanding of the oral environment into which the restoration will be placed.
- The biologic knowledge necessary to make the previously mentioned determinations.
- An understanding of the biologic basis and function of the various tooth components and supporting tissues.
- An appreciation for and knowledge of correct dental anatomy.
- The effect of the operative procedure on other dental treatments.
- Although tooth preparations for operative procedures originally adhered to the concept of “extension for prevention”, increased knowledge of prevention methods, advanced clinical techniques, and improved restorative materials have now provided a more conservative approach to the restoration of teeth.
- This newer approach is a result of the reduction in caries incidence because of increased knowledge about caries, increased preventive emphasis, use of multiple fluoride applications, and proper sealant application.
The primary results of conservative treatment are retention of more intact tooth structure and less trauma to the pulp tissue and contiguous soft tissue.
Development in Field of Operative Dentistry
- Development of high speed handpiece played a dramatic role in more conservative and efficient removal of tooth structure for restorative procedures.
- Mechanical bonding to tooth structure by etching and dentin bonding has led to conservative bonding techniques.
- Increased knowledge about carious process and beneficial effect of fluoride has laid emphasis on prevention of caries.
- Increased research on dental biomaterials has led to vastly improved dental materials.
All these process have led to a more conservative and effective restoration of tooth structure.