I feel it is important to review the concepts of HOLDING vs. GOAL oriented dentistry and FILLINGS vs CROWNS, as this may be confusing to many of you. I define holding dentistry as the minimum amount of dentistry that can be done in order to stop disease. This puts someone in a situation where they can keep their own mouth free from active dental disease. It may involve compromises in the type of restorations that are done (where teeth have been lost the space may not be filled or a large filling may be done instead of a crown). Goal oriented dentistry is doing the "ideal" type of dentistry and the most long lasting. "The same thing I would want for myself or someone in my immediate family in the same situation."
A filling is a dental restoration that requires tooth to support and protect it and is indicated where there is a small amount of decay and in areas where there is a minimum amount of stress or pressure. In this case a filling is the treatment of choice and would be considered "goal" dentistry. When areas to be repaired are large, there may not be sufficient tooth structure left to protect the tooth in the long run. Since fillings are "relatively" soft they can wear and the bite can shift and move. Fillings can leak and crack AND if there is not sufficient tooth structure the tooth itself can break or crack. Crowns are the restoration of choice when there are large cavities or large areas of broken tooth since Crowns are very strong and long lasting if taken care of properly. They are usually required in situations where missing teeth are to be replaced, and are often the best way to establish and maintain a correct bite relationship.
The misunderstanding may arise as to why a person should make changes and work towards an ideal GOAL when they have had successful holding dentistry for years. I think it can be simply stated as wanting to get ALL parts of ones body into an optimum state of health; to think that one has achieved an optimum state of health in other parts of their body and not their mouth or vice versa is absurd. I feel that TOTAL HEALTH or the degree of total health one wants to achieve is a decision you have to make for yourself. By recommending and emphasizing the advantages of "GOAL ORIENTED DENTISTRY I hope that you will want this type of dentistry- for yourself if you haven't achieved it already.
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