Contents:

• Restorative Dentistry
• Problems
• Caries
• Diagnosis
• Treatment and Restoration
• Symptoms
• Endodontics
• Price List
• FAQ
• Contact

Healthy, natural teeth are the most valuable element of every smile. We have advanced methods for tooth reconstruction, endodontic treatment, prosthetics, and implantology. However, the basic principle remains unchanged – if a natural tooth can be effectively and predictably preserved, it’s worth doing everything possible to ensure this happens.

Most patients associate conservative dentistry only with fillings. However, this field encompasses much more! Its mission is to diagnose and treat diseases of the hard tissues of the teeth, primarily caries, but also damage resulting from erosion, abrasion, attrition, overload, or trauma. It also includes the reconstruction of teeth after loss of structure and measures to reduce the risk of recurrence.

What is conservative dentistry and when is it worth seeking treatment?

Conservative dentistry addresses diseases and damage to teeth that can lead to the gradual loss of their structure. Within this field, we address everything from minor caries to extensive lesions requiring advanced restoration. Diagnostics also include:

• hypersensitivity,
• tooth cracking,
• changes in tooth shape,
• enamel abrasion,
• cervical cavities,
• problems related to an old filling.

It’s important to distinguish between two concepts: dental disease and its symptom. Pain is not a disease in itself. It’s a signal that can have various causes. Importantly, its absence does not mean that the teeth are healthy. Caries in its early stages can develop asymptomatically – the patient may only notice the problem when the process affects the deeper layers of the tooth.

This is why conservative dentistry has two fundamental dimensions. The first is treating the existing disease. The second is preventing its progression and detecting changes at the earliest possible stage.

What problems does conservative dentistry treat?

Tooth decay

Dental caries is a disease dependent on many factors. Bacteria present in dental biofilm metabolize easily fermentable carbohydrates. This leads to the formation of acids, which disrupt the balance between the demineralization and remineralization processes of tooth tissue.

At first, the lesion may be subtle and cause no symptoms. The patient may not even be aware that the disease process has already begun. As it progresses, subsequent layers of tissue are lost, and a cavity forms in the tooth.

Enamel erosion

Erosion is the chemical dissolution of hard tooth tissues by acids that do not originate directly from carious bacteria.

Sources of acidification include carbonated drinks, energy drinks, acidic foods, and frequent exposure to an acidic environment. Factors related to gastroesophageal reflux can also play a role.

This problem leads to gradual thinning of the enamel, increased translucency of the incisal edges, changes in tooth shape, and tooth sensitivity.

Abrasion and attrition

Teeth can also wear mechanically. Abrasion is associated with the mechanical abrasion of tooth tissue by external factors. One example is overly aggressive brushing, especially with incorrect technique.

Atrition, on the other hand, is the result of tooth-to-tooth contact. To some extent, it is a natural part of dentition, but excessive abrasion can be pathological. Bruxism can be a contributing factor to excessive tissue loss.

Tooth decay. How does a tooth develop, develop, and deteriorate?

Dental caries is one of the most common dental diseases. Bacterial biofilms constantly form on the tooth surface. Microorganisms found in dental plaque can utilize dietary sugars and produce acids. Repeatedly lowering the pH in the plaque environment promotes demineralization of enamel and dentin. If the balance between demineralization and remineralization is permanently shifted in an unfavorable direction, carious lesions gradually develop.

The risk of developing dental caries depends on the amount of sugar consumed and its frequency. Constantly snacking or regularly sipping sweetened beverages can mean repeated exposure of teeth to an unfavorable environment. Saliva composition, its flow, oral hygiene, fluoride content, the anatomy of the tooth surface, and the patient’s general condition are also important factors, as are certain medications and diseases that affect salivary flow.

The first stage of dental caries may be a subsurface lesion and does not necessarily mean the formation of a classic “hole.” White, opaque areas may then appear on the enamel, signaling a mineralization disorder. If the process occurring in the oral cavity is recognized at this stage, non-invasive treatment is possible to halt the progression of the lesion. However, if a cavity develops in the enamel or dentin, restoration treatment will be necessary.

Dental diagnostics

Effective dental treatment begins before using a drill. Our first task is to determine what’s actually happening with the tooth. During the examination, we assess the condition of the enamel, dentin, existing fillings, proximal surfaces, the cervical region, and the tissues surrounding the tooth, among other things. We also analyze the patient’s symptoms.

If deeper caries or lesions invisible in the oral cavity are suspected, we use radiographic examinations. This is particularly important for caries developing in the interdental spaces – its initial stages can be difficult to assess with a visual examination alone. However, it’s important to emphasize that an X-ray does not replace a clinical examination. It complements it. Only a combination of the interview, clinical examination, and—if warranted—imaging diagnostics can provide a complete picture.

Dental diagnostics allow us to answer the question of whether a given tooth actually requires treatment and how extensive it should be.

Not every discoloration around a filling automatically indicates secondary caries. Similarly, not every old filling needs preventative replacement. The decision should be based on its condition, tightness, function, presence of carious lesions and the risk of further problems.

Conservative treatment and tooth reconstruction

We always select the tooth restoration method based on the extent of tissue loss. We typically use direct composite fillings. The material is introduced directly into the prepared cavity, then sculpted and cured accordingly.

Modern composites allow for very precise tooth shape reconstruction. Aesthetics—color, translucency, shape, proportions, and light reflection—are particularly important in anterior teeth. However, in posterior teeth, the anatomy of the chewing surface, contact points, and proper occlusal contact are equally important. The filling is intended to recreate the functional portion of the tooth.

For more extensive defects, the situation is somewhat more challenging. If the patient has lost a significant portion of the tooth’s crown, a traditional filling may not provide sufficient protection for the remaining tissue. In such cases, we recommend a more advanced restoration—an inlay, onlay, overlay, or a prosthetic crown. The choice depends on factors such as the amount of tissue remaining, the tooth’s location, its load, the condition of the pulp, and the occlusal conditions.

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Hypersensitivity, toothache and other warning signs

As we’ve already mentioned, not every toothache indicates advanced disease! However, any persistent or unusual symptom deserves attention.

Hypersensitivity can occur with exposed dentin, gingival recession, erosion, abrasion, caries, etc. Characteristically, these symptoms are characterized by a brief, sharp reaction to cold, heat, sweetness, or touch.

Pain associated with pulpitis may present differently. Pain that persists after the thermal stimulus has subsided, is spontaneous, worsens at night, or is difficult to localize is of particular diagnostic importance. Endodontic terminology distinguishes between normal pulp, reversible pulpitis, symptomatic irreversible pulpitis, and pulp necrosis. A diagnosis is always made based on subjective symptoms and clinical examination results, not just the patient’s reported pain level.

It’s also important not to assume that the absence of pain means there’s no threat to the tooth. Some disease processes can remain asymptomatic for a long time.

If you experience pain, sensitivity, discoloration, cracking, chipping, swelling, or difficulty biting, it’s worth consulting a dentist.

How does conservative dentistry save a tooth from root canal treatment?

One of the most important goals of conservative treatment is to maintain a tooth in a biologically functional state for as long as possible. If caries is shallow, the problem may only affect the enamel and dentin. However, if the process reaches the pulp, the situation becomes much more complex.

The pulp is the living tissue inside the tooth. Its condition can change as decay progresses. Deep cavities can lead to pulp irritation or inflammation. However, this doesn’t mean that every deep cavity automatically requires root canal treatment. If the tooth’s pulp is capable of functioning properly, we use restorative methods to protect it.

However, if irreversible pulpitis or necrosis develops, endodontic treatment may be necessary. Its goal is to remove infected or irreversibly decayed tissue from the tooth’s interior, properly prepare the root canal system, disinfect it, and then securely fill it.

From the patient’s point of view, one conclusion should be the most important – do not wait until a minor problem becomes an endodontic problem.

Conservative dentistry – price list

Frequently asked questions about conservative dentistry – FAQ

Conservative dentistry Krakow – contact us!