General dental care involves the basic services you traditionally see a general or family dentist for. These include cleanings, fillings or other tooth repair restorations, and the replacement of missing teeth (see “Restoring Damaged and Unattractive Teeth” and “Esthetic vs. Cosmetic Dental Treatment”). It should be understood that this office and Dr. Hegyi also provides these types of services. However, it is our belief that how and when these treatments are provided should be influenced by two very important factors – the patient’s biomechanical and periodontal health status (see “Dental Biomechanical Harmony – the Key to Predictable Dental Comfort, Health, and Esthetics”, “Biomechanical Disharmony – Problems, Evaluation, and Treatment”, and “Periodontal Disease, Tooth Loss, and Whole Body Health”).
Periodontal Health and General Dental Treatment
If a patient has periodontal disease, treating this infectious and contagious disease is one of the very first problems that should be addressed. Eliminating or stabilizing this disease is often done as a “first phase” of treatment along with eliminating tooth decay – both of which are caused by bacteria. It is absolutely critical that both are either eliminated or stabilized prior to doing any reconstructive or esthetic treatment. Therefore, placing restorations such as crowns, onlays, veneers, and bonding, or orthodontic treatment should only be considered after periodontal problems have been addressed.
In addition, it is important that these treatments be done in a way that they do not unintentionally contribute to the development or worsening of periodontal disease. This can occur if either the fit between the restoration and tooth is not ideal or if the resulting bite is not in harmony with the jaw muscles, jaw joints, and other teeth.
Biomechanical Health and General Dental Treatment
The relationship between biomechanical health and general dental treatment is a two-way relationship. Problems with biomechanical disorders such as bite problems or damaged jaw joints place increased stresses on all structures within the mouth, including the periodontium, teeth, and restorations. As a result, periodontal problems may develop or worsen, and the teeth may experience loosening, breakage, and excessive wear. These same stresses may also have a very harmful affect on any type of dental restoration. Regardless of the restoration type (including fillings, crowns, onlays, veneers, and bonding), their longevity will be significantly reduced as a result of excessive biomechanical forces. These forces are the number one cause of fracture and failure of any type of restoration dentists place.
Conversely, improperly designed dental restorations are a major cause of biomechanical disharmony. When the shape or contour of the functioning portion of a restoration is not in harmony with the healthy functioning of the jaw muscles and jaw joint, the resulting stresses can cause pain and damage to any part of the jaw system. Many patients are aware of their bite feeling different after having a crown or a filling done. However, what they are typically not aware of is the problems this might cause for them in the future. It should be the objective of every restoration a dentist places to contribute to biomechanical harmony and not cause disharmony.