Oral Health Group

Proactive Intervention Dentistry: Nurturing the Oral Environment

December 10, 2019
by Fay Goldstep, DDS, FIADFE, FASDA

“Environment” is a real buzzword in the news today. Pollution, climate, sustainable, maintainable, crisis, emergency. Do we have control or not?

One area where we as dental professionals have some control is the oral environment! We are the custodians of our patients’ oral environment. Of course, things can spiral out of control when our patients do not heed our instructions and advice. But ultimately, we are charged with nurturing their oral environment. Decisions that we make on preparation techniques, restorative materials, and oral hygiene products impact on the maintainability and sustainability of our patients’ oral health.


“Gum gardeners” is a joking way that periodontists sometimes refer to themselves. I would like to suggest that all dental professionals are “oral environment engineers” or “gardeners” whose task it is to create the right environment for optimal patient healing and consequent optimal and sustainable oral health outcomes.

How can you achieve these goals?

Education…education…education. This is possible today through a multitude of formats. Stick with the method that works best for you—lecture, live webinar, online on-demand streaming, print publication, online articles, etc., and you will be successful in your quest! Keep an open mind but do not be too quick to give up the tried and true methods. Do not adopt a technique that runs counter to the basic principles of science, engineering, and artistry that you have absorbed from experience in your clinical practice.

Let’s start right now with some help from this issue of Oral Health Journal…

The Biologically Oriented Preparation Technique allows the clinician and lab technician to interact and modify gingival tissue by creating restorations where the gingiva adapts and settles around new forms and profiles that are optimal for sustainable periodontal health and ideal esthetics.

Bacteria are known to be culprits in the etiology of tooth decay. Is it possible that inflammation also plays a factor? Can this affect the caries risk profile of patients with inflammatory disease or altered immune system function? Will this affect preventive therapies for these patients?

It is key to preserve and maintain intact bone anatomy for dental implant placement in the rehabilitation of esthetic areas. Partial Extraction Therapy prior to immediate implant placement involves the sectioning and removal of the crown of the non-restorable tooth, and then leaving part of the root, in order to avoid buccal bone wall resorption that usually follows conventional tooth extraction.

Anterior composite incisal rehabilitation using a minimally invasive composite resin approach is predictable, sustainable and very patient friendly.

Fibre reinforcing of composite resin improves its fracture strength and enables dentists to unleash new clinical applications of direct materials, thereby providing patients with alternatives to indirect restorations.

The general dentist is overwhelmed and intimidated by the surgical component of implant placement. Computerized treatment planning and “open system” surgical guides can provide improved simplicity, accuracy and predictability.

We have primary control of our patients’ oral environment. We can nurture it to be maintainable and sustainable with our proactive intervention treatment decisions. This is the tremendous responsibility that we undertake every day…

About the Editor

Dr. Fay Goldstep, has lectured nationally and internationally on Proactive/Minimal Intervention Dentistry, Soft-Tissue Lasers, Electronic Caries Detection, Healing Dentistry and Innovations in Hygiene. She has been a contributing author to four textbooks and has published more than 100 articles. She sits on the editorial board of Oral Health. Dentistry Today has listed her as one of the leaders in continuing education since 2002. Dr. Goldstep is a consultant to a number of dental companies, and maintains a private practice in Richmond Hill, Ontario. She can be reached at goldstep@epdot.com.

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