CONCLUSIONS
I am not going to say that this approach is suitable for every practice, but every practice could take part and use it as required.
Cost. In relative terms, it costs very little to risk assess our patients for caries and other illnesses. More use of questionnaires is not expensive. The mercuric amalgam may cost slightly less as against the newer improved biomimetic products, but it is far outweighed by the benefits of these products …. ease of use/aesthetics/biocompatibility. The longevity of non-amalgam materials is now up there with that of amalgam. Look at the number of countries that have banned its use. What would your preference for filling material mercuric amalgam or a biocompatible option?
Safety. The risk assessment of diet and bruxing can be done at home before a visit online or in the practice by using a tablet with the mobile technology the vast majority of us are now familiar with.
NHS/ Private. All practices and dentists have to decide what is best for themselves and their patients. They have to choose when to stay in and uphold the NHS system. This time, more than any, is the time to decide what you will do regarding private and NHS. The MID format of dentistry has no boundaries it is not governed by rules, regulations and targets as those within the NHS. Dentistry has been reset, and we shall see reviews of contracts and regulations.
Science and evidence-based. These principles, products and techniques are evidence-based. Tried, tested and proven. Careful and full note taking at all stages and patient acceptance noted. Patient compliance is essential. We should investigate and look into what we have out there in the dental world as it is so exciting, helping us through this critical and immensely stressful time. We have to retrain our practice and practices massively. AND OUR TEAM! We have to look at alternative treatment methods and move away from invasive treatments. We have to look around as to what we have available. We have products that AVOID drilling entirely! We can move away from a drill and fill culture. Repair instead of replace!
Anecdotally. Older materials with precious metals seem to have had quite a success rate yet have been overtaken by newer more expensive materials. G.V.Black used silver nitrite to treat children’s teeth and it has been used in Japan for over 50 years. Zinc phosphate is one of the oldest and widest-used cement/liner and has proven antibacterial properties. Amalgam contains several precious metals. Copper has now been recognised as useful in the current virus fight such that handles are being replaced with copper. Gold is still the “Gold Standard “ as a restorative material!