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Biomedical subjects

R J Elderton

Publications and source records attributed to R J Elderton.

At least 37 records · Page 2Linked to original sources
PubMed1991

Preventive versus restorative management of dental caries.

Dental caries is a preventable disease and established lesions can become arrested. Traditional restorative treatment has many shortcomings and there is a need for dentists to manage carious lesions as far as possible by preventive means. Patients should be motivated to accept responsibility for changing the environment of their teeth so that the calcium and phosphate balance favours remineralization, but the dentist should still make use of therapeutic fissure sealants or place restorations when necessary. As long as dentists continue to be obsessed with a restorative approach to caries management, the repeat restoration cycle with its accompanying escalating costs seems likely to continue. The implications of this change in philosophy are enormous, for areas of the world where oral care services are comprehensive, and for countries like South Africa where services are still being developed in some regions.

Dental Caries↗
PubMed1990

Changing perceptions of the requirements of cavity preparations.

Perceptions of the requirements of cavity preparations have changed over the years. These have had a significant effect on undergraduate teaching at the University of Bristol Dental School, an explanation of which may help general dental practitioners in their quest for information on this important aspect of dental practice. A method is described for teaching undergraduate dental students cavity preparation in caries-free teeth, based upon the position, shape and extent of imaginary carious lesions. Scale diagrams of teeth are used, on which imaginary caries at the amelodentinal junction has been marked. The students are instructed to apply the principles of cavity preparation to equivalent, but caries-free, teeth in the laboratory. 'Outline forms' and other predetermined cavity shapes are not taught. Dental practitioners may find it appropriate to apply similar thinking to cavities they prepare in everyday practice, in an endeavour to avoid the unnecessary removal of tooth tissue that would be better retained.

Audiovisual Aids↗
PubMed1990

Clinical studies concerning re-restoration of teeth.

Re-restoring teeth is an important component of operative dentistry, and the perceived presence of secondary caries is a major reason for undertaking it. In the absence of a diagnosis of secondary caries, a morphological discrepancy at the margin of a restoration commonly provides the necessary justification for replacement. However, several studies have demonstrated enormous variation among dentists, both in their diagnosis of secondary caries and in the clinical decisions they make regarding whether or not to restore or re-restore. Many of these decisions must have been wrong. Decisions to re-restore teeth have been shown to be particularly idiosyncratic, and some patients apparently become involved in a repeat restoration cycle whereby the more restorations they have, the more re-restorations they receive. The desire by some dentists to replace large numbers of restorations, for reasons other than the presence of disease, shows a fallibility of operative treatment. At the same time it suggests that these dentists have considerable faith in this aspect of dental care. There would appear to be a prima facie case for investigating more deeply the factors involved in the clinical assessment of restorations. It should then be possible to improve the standard of diagnosis and treatment decision-making, especially with respect to the need to re-restore teeth.

Decision Making↗
PubMed1989

Keeping up-to-date with tooth notation.

Methods of tooth notation have evolved over the years and there is now an increasing desirability for a system which offers the maximum in precision, clarity and compatibility with typing and computing requirements. A review of the many available methods leads to the FDI two-digit system as being highly appropriate for today's needs. This system is being adopted increasingly, worldwide.

Dental Records↗
PubMed1988

Restorations without conventional cavity preparations.

Dentists in developed countries tend to provide highly restoration-oriented dental care, yet recent research has shown that restorations have many shortcomings and that a costly and repetitious restorative cycle is easily established. In particular, caries diagnosis and restorative treatment planning are subject to considerable idiosyncrasies. Coupled with mediocrity in cavity preparation and restorative technique, this results in many restorations having poor life expectancy. The non-invasive management of small carious lesions in a manner that will bring about some remineralization offers, under certain circumstances, a viable and superior alternative to conventional restorations. However, carious lesions in smooth surfaces of the teeth present very different diagnostic and assessment problems from those in fissured surfaces and the methods of clinical management differ markedly. Fissure sealants have been applied to early or moderately sized pit and fissure carious lesions in many studies during the last 20 years. Where the sealant has remained intact, evidence has been provided to show that the caries has not progressed. There would seem, therefore, to be a strong case for using fissure sealants more widely in the management of pit and fissure lesions and, in this way, to provide restorations without cavity preparations. In situations where invasive procedures are required, conventional 'Black' cavity preparations should not be used. Rather, they should be ultra-conservative and of very high quality. Clearly, a preventive philosophy in caries management should actively be encouraged in countries with developed dental services.(ABSTRACT TRUNCATED AT 250 WORDS)

Composite Resins↗
PubMed1985

Dental health services research in Scotland: a review of some 5-year results.

A longitudinal study of dental treatment carried out by the Dental Health Services Research Unit in Dundee has provided a unique opportunity to investigate a variety of aspects of dental care received by a sample of dentate individuals over 5 yr. The distribution of treatment indicated that frequent attenders, especially those who changed dentist, were particularly prone to having teeth filled and that two-thirds of the restorative cost was spent on restoring tooth surfaces that had previously been filled. A quarter of the sample had severe periodontal disease and they tended to visit a dentist less frequently than those with mild periodontal disease. They were also more likely to have teeth extracted but less likely to have a scaling or other periodontal treatment than the moderately diseased. The findings suggest that there is considerable scope for a less treatment-orientated approach to the management of dental caries for those who currently receive most of the restorative treatment. The majority of the population who receive little dental care, especially those with severe periodontal disease, would probably gain by visiting a dentist more frequently. Dentists need to acquire a more positive attitude towards prevention and an increased ability to make intellectually based decisions not to treat.

Adult↗