Changing with the times to meet expectations – Mark Allen Coltene

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  Posted by: Dental Design      11th April 2019

Fans of historical dental facts will know that it was not uncommon for younger people to have healthy teeth pulled and replaced with dentures as recently as the 1960s. For young women, a set of dentures could even be given as a birthday gift, or as part of their wedding dowry.[i]Especially pre-NHS, this saved the husband-to-be the cost of future care, and dentures looked better than a mouth of crooked or rotten teeth.

Of course, with vast improvements in the nation’s oral health, more adults are keeping more of their own teeth for longer. According to the last Adult Dental Health Survey, just six per cent of adults were edentate in 2009, compared with 28 per cent in 1978 (figures relate to England, Wales and Northern Ireland).[ii]Dentures are now far from a status symbol. Most people would baulk at the idea of removing their teeth at night, like grandma did; the thought of embarrassing slippages is often too much to contemplate for patients, young and old.

Patients’ needs, wants and expectations have been transformed over the last few decades, keeping pace with massive changes in the dental industry. Expectations are sky-high and dentists must deliver. The pressure to keep up with research and development, to learn contemporary techniques and trial the cutting-edge products, tools and materials introduced on to the market will keep forward-thinking practitioners motivated and inspired. Being able to find solutions to dental problems that would previously have been out of reach, and passing these benefits on to the patients is what makes dentistry such an exciting – yet challenging – place to be. Patient loyalty is a thing of the past, and if dentists don’t tap into what people want, and provide it, they will struggle to maintain pace with their competitors. The way feedback is often disseminated in our social media age, when a practice’s or practitioner’s reputation can be permanently tarnished and they may end up being the last to know, is frustrating, but it is the new reality. Striving for excellence in every area is the only way to meet the expectations of a patient base who want fantastic results, great value and a commitment to their long-term care.

Back to our 1960’s bride who switched healthy teeth for dentures, smile makeovers – the quest for a perfect, white and straight smile – meant aggressive preparation in the not-too-distant past. The routine removal of healthy enamel and dentine, so the fundamental tooth structure, was considered normal, and part of the process if a patient wanted perfection. Then things started to change. For example, minimally invasive and ethical orthodontic options were successfully trialled and are now considered mainstream, both in the UK and overseas. Avoiding the need for aggressive preparation and healthy tooth removal, these appliances can fix issues like protrusion and crowding in less than six months with stable long-term results, representing good value for the patient. In restorative dentistry, we have also seen the growth of conservative, minimally invasive techniques and materials that allow the dentist to give patients a comfortable and quick experience, and leave with a natural smile after far less chair time.

This takes us back to patients’ needs and wants, as well as their expectations. Patients want a naturally beautiful and healthy-looking smile. Ultra-bright, obviously veneered teeth are just as much of a joke as dentures have become. The idea of unnecessary pain and discomfort to achieve an improved smile isn’t attractive to most either. Repeat dental visits – and the ensuing cost in time and money – are also not very appealing. A dentist who, with the correct technique and careful material selection, can let the patient see great results in the form, shape and colour of restoration(s) will enhance their reputation through positive word of mouth from satisfied patients.

With a conservative approach, which preserves as much tissue as possible, the longevity of a restoration can be extended. Dentists who perform restorative work should seek out materials that facilitate an efficient way of working; both they and their patients will reap the benefits. Fill-Up!bulk fill composite from COLTENE, is not only fast, reducing treatment time, but also a good choice aesthetically. BRILLIANT EverGlow® universal composite, also by COLTENE, is a hard-working all-rounder, offering easy, efficient handling as well as long-lasting gloss and shade aesthetics.

What do patients want? So much – and why shouldn’t they? Dentistry has come on leaps and bounds and practitioners must share the amazing developments with the people who put their trust in them. Restorative dentistry can be conservative, comfortable and does not always require heavy prep if the dentist has embraced the very best technology, techniques and materials on the market. With such quality products out there, treatment can be efficient, minimally invasive and performed without compromise to a beautiful, natural looking end result.


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[i]Smile a perfect smile, but don’t laugh… we have officially lost our dentures. Independent, June 1996. Link: October 2018).

[ii]Adult Dental Health Survey 2009 – Summary report and thematic series. Published 24 March 2011 by NHS Digital. Link: October 2018).

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