These new guidelines are not especially revelatory, but it is good to confirm proper care procedures for restorations, as well as understand how little evidence we really have on some aspects of dental care.
Basic Care Is Good
The new recommendations show that in most cases, no special care is required to ensure the long life of dental restorations. In general, treating them as well as you should treat natural teeth will give your restorations a long life. Restorations covered by these guidelines include porcelain veneers, dental crowns, dental bridges, and full dentures, whether supported by natural teeth or dental implants.
The ACP upholds the basic principle of seeing your dentist every six months to ensure proper care for restorations. The guidelines also remind dentists and hygienists that they should clean both natural teeth and artificial restorations thoroughly. When cleaning restorations, the ACP guidelines note, providers should use tools appropriate for the restoration.
For home care, the ACP recommends twice daily brushing with a soft tooth brush. It doesn’t give specific recommendations for toothpaste, but it’s best to avoid anything that is described as “whitening” or is too abrasive. There’s no need to invest in fancy toothpaste–restorations are durable enough to stand up to most toothpastes.
People should also use a supplemental cleaning tool to clean between teeth and restorations, as well as at or below the gum line. Flossers, water cleaners, and air flossers are all recommended aids for cleaning.
If you have multiple or complex restorations, it’s recommended that you use a chlorhexidine mouth rinse and a high-fluoride toothpaste with triclosan antibiotics.
More Study Is Needed
Although most of the recommendations are themselves pretty mundane, the startling thing about the ACP’s recommendations is how little evidence there is to support them. All the recommendations are rated based on the quality of evidence supporting them, which ranges from A to D, highest quality to lowest. Most of the guidelines only have evidence level D. The only things that get an “A” are getting professional cleanings (but the frequency isn’t supported by good evidence), brushing twice a day and flossing daily, and the extra care required for complex restorations.
Hopefully, now that we know where work is needed, new studies can be done to improve our understanding of how to care for restorations. If you are looking for restorative dentistry in Rochester, NY, or a dentist to help care for your teeth, please call 585-244-3337 for an appointment at Contemporary Dentistry.