When helping patients decide on their dental care, Manhattan dentist Dr. Lawrence Wang, who runs Madison Square Dentistry, specializing in cosmetic and restorative dental procedures, conducts personal consultations and evaluates each case on an individual basis to find the most conservative, or least invasive, course of action. What does it mean for a dentist to have a conservative treatment philosophy?
A conservative treatment philosophy can save you from more extensive (and expensive) treatment, as well as save you time. Here are some scenarios in which my treatment philosophy is applied:
1. I use white (composite) instead of silver (amalgam) fillings for cavities because with silver fillings, you have to remove a lot of the tooth structure for the filling to stay in. With a white filling, you don’t have to remove as much of the tooth structure. You can literally glue in a white filling, while with a silver filling, you have to do mechanical undercuttings and remove healthy teeth. Also, you always have to use Novocaine with silver fillings, while with white fillings you don’t have to use it half the time, because they don’t hurt as much. This is important to conserving tooth structure and making the experience less painful and uncomfortable for the patient.
2. I often recommend Six Month Smiles braces to patients instead of veneers, although I do put on veneers. Veneers are thin sheets of porcelain that are bonded permanently to the front of your teeth, which look and feel like natural teeth. It is a much more invasive procedure that requires the dentist to remove part of the tooth enamel, enabling them to fit the veneers over your real teeth. Six-month braces are tooth-colored braces for adults that are placed only on your front teeth — the goal is to improve your smile. Despite the short treatment, teeth are moved with low force and carefully designed technology, resulting in less discomfort than normally associated with traditional braces.
3. The standard procedure for people with severe gum disease is to get gum surgery, where the doctor has to cut through your gums to remove the infection. We recommend a far less invasive procedure: Our gum-disease patients wear antibiotic-filled trays on their teeth for several months which clear the infection over time. This antibiotic treatment was only recently approved by the FDA, and is now a viable alternative to gum surgery. The drawback is that the results are not immediate — it takes longer for the infection to go away. But gum surgery is more expensive than antibiotic trays, your diet is very restricted afterward, and your gums are sore for several weeks after the surgery. The tray is like a small mouth guard, which is customized for each patient, containing an antibiotic gel. The tray forces the gel under the gums.
The information in the article is not intended to substitute for the medical expertise and advice of your healthcare provider. We encourage you to discuss any decisions about treatment or care with an appropriate healthcare provider.
