Just How Long Is Forever?
Authored by Ronald E. Goldstein, DDS and David A. Garber, DMD
 
Journal of Esthetic Dentistry : Volume 8, Number 1
 
Despite all that we know, we humans exhibit a curious tendency to expect things to last forever: all kinds of things. We act surprised when our cars break down. We rail at our computers when they malfunction. We become angry and frustrated when our (formerly dependable) bodies show signs of wear and tear. Is it really any wonder then, that we expect dental restorations to last forever? But we do, and too often we pass that expectation on to our patients. Instead, we should be sharing with patients our confidence in our good work along with a realistic appraisal of the life expectancy of the restoration, as well as tips to maximize its usefulness. It is up to us as practitioners of conscience to develop and share with our patients a realistic expectation of our own limitations. In the consumer book, "Change Your Smile,' Goldstein includes the anticipated life expectancy of various treatments and restorations. Patients need and deserve this information.

We also may be failing our patients by encouraging them to endure their amalgam restorations until they fall out. One has only to gaze into the eyepiece of an intraoral camera and examine the margins of these gaping, macroscopic, bacteria-collecting voids to realize our error in judgment. Our ego-involvement in the restoration "that lasted 25 years" must never take precedence over the issue of serviceability. False pride at what cost?

It is undeniable that the newer restorative materials offer tremendous functional and esthetic benefits for us and for our patients. But a "permanent restorative material" continues to elude us as we move into the final years of the 20th century. For the moment, then, we must continue to pursue the art -- and science -- of maintaining esthetic results. This includes proper home care, maintenance, and periodic replacement of restorations. We realize, for example, that after beautiful orthodontic therapy, teeth will continue to move, and therefore, the concept of retainers for a lifetime is not unrealistic. Similarly, maintenance of implants and bleached teeth, toothbrush use, and prevention must be among our chief concerns as our patients strive to maximize the beauty and usefulness of their restorations.

To that end, the articles in this issue of the Journal of Esthetic Dentistry offer welcome assistance. We are delighted that Tom and Marilyn consented to complete the excellent job they began in Volume 7, Number 5, our first special issue on maintaining esthetic restorations. We hope you will agree that they have attracted a group of outstanding authors whose fine articles deliver pertinent and much-welcome information Our best wishes to each of you in your own efforts in this area.

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