Defining oral rehabilitation

Defining oral rehabilitation
Gordon J. Christensen, D.D.S., M.S.D., Ph.D. J Am Dent Assoc, Vol 135, No 2, 215-217. © 2004 
The phrase “oral rehabilitation” means different things to different people. It is amazing to see the range of treatment that can be called an “oral rehabilitation.” (…) An oral esthetic upgrade can require one of several levels of oral rehabilitation, ranging from conservative to relatively radical. Because of commercial television hype and lay publications about esthetic/cosmetic dentistry, patients have been led to believe that their appearance can be improved only by bleaching, a major redo of the existing tooth restorations and esthetic recontouring of the teeth with veneers or crowns—even to the extent of crowning all of the teeth. These false beliefs are causing needless removal of tooth structure, unnecessary cost to patients and placement of restorations that have a finite life span and will need to be replaced within a few years. Additionally, some commercial institutes and continuing education groups are advertising to the lay public that only “graduates” of their programs are capable of accomplishing the type of oral rehabilitations observed in the television cosmetic makeovers. This, of course, is not true.  (…)
Treatment of Defective Teeth Only
Many patients do not require or desire an esthetic upgrade in their oral appearance. They are pleased with their appearance, although it may not be perfect by ideal standards. They want long-lasting, comfortable dental restorations and a reasonable smile. They do not seek the glamorous, but often short-lived, esthetic restorative therapy popularized on television. When treating these patients, the practitioner often need perform only conventional dental therapy. (…)  
Adequate completion of this minimal treatment can be termed an “oral rehabilitation.” Any competent general dentist should be able to provide the therapy needed for these patients. (…) 
Summary   “Oral rehabilitation” is a phrase that is used to encompass several levels of oral therapy. Usually, dentists think of an oral rehabilitation as meaning restoration of all of the teeth in a given mouth. However, when only the defective teeth in any mouth are restored, that too could be defined as an oral rehabilitation. The advent of esthetic dentistry has encouraged oral rehabilitation for esthetic reasons only. This article suggests that such oral rehabilitations should be preceded by thorough informed consent and education about other, more conservative, therapies. Patients should have full knowledge that such rehabilitations are not required, and that they may require frequent re-treatment at significant cost. Qualified specialists or experienced general dentists are capable of treating all levels of oral rehabilitation, and completion of courses at specific commercial institutes is not necessary.

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