Good dental treatment is designed to last

By Dr Bertrand R. Stuart
It is unfortunate. but I see a good deal of dental work done and it almost seems that they are designed to fail within a few years. When we are doing dentistry, we are not dealing with disposable razor blades. What do I mean by that? Well, Gillette and Schick figured out long ago that they could give you the razor blade handle for free because they were going to charge you for the disposable razor blades. Once you have the handle, you will be paying for blades for a very long time.
Dentistry done well should not be like that. We design our care so it can last.
I like to use a concept that has helped structures through-out history last for a long time. The roads, buildings and aqueducts made over a hundred years ago that are still standing were built with the concept of over-engineering. These ancient engineers knew that they had to build structures that could withstand weather, man and time. They had to build structures that were over-engineered, so that the stresses of use would not weaken the materials and cause the structures to fall. It was too costly to have it fail before its time.
Today, most modern bridges and buildings meant to last are built with these concepts in mind. Take, for example, the Berbice Bridge. Clearly, the smart engineers built it so it can withstand five times normal weights and stresses it most likely will face from pounding of trucks and cars crossing it. This is the insurance that it will last.
All materials wear out with time. The combined weights of the vehicles, forces of wind and rain, normal wear and tear, even gravity weaken structures over time. When a structure is built to withstand five or ten times the normal load bearing capacity, the stresses of use are minimal. In the case of a bridge, it can last for hundreds of years. We dentists, who can be considered to be oral engineers, are trained to do the same. We over-engineer your dental work so that it can last many years, even decades. We create the capacity for it to withstand the biomechanical stresses of everyday chewing, smiling and living. This is why some of us think in terms of thirty years of service or more.
The problem of engineering for “just the right amount” is what happens when the work is stressed beyond normal. Will it fail? Are you willing to risk it? Would you buy an insurance policy that was good for only half the time? What if you got unlucky and the day you needed it, you were not insured? We do not want to count on luck. Everyone wants to be sure. Don’t you? However, over-engineering does take more time, effort and energy and does cost a bit more. The result is long lasting dental work that looks good, feels good, lasts, and gives you piece of mind. The value of that is immense to you. I am sure you would agree.
There is a lot of dental work done for expedient reasons and will be lucky to last for five years. It is typically under-engineered. The sad truth is that unless you are a smart dental consumer who knows what to ask for, you could be fooled into thinking you are getting something you are not. So, do not fall into the trap of “Scotch Tape dentistry.” It binds parts together and maybe does not look too bad, but it is a classic example of under-engineering care that if destined to fail, often at the worst possible time.
So how should you know when your dental work is under-engineered? Well, your assessment should be evidence based. Has your dentist been practising for many years? If not, he or she may not be too experienced. What about your dentist’s demeanour? Is he or she willing to patiently answer your questions about your treatment procedures? If not, maybe he or she is “bluffing.” Is your dentist over-emphasising his or her fee rather than explaining the details of your problems. If the answer is “Yes”, then your dentist is more of a business person rather that a sympathetic dental professional. Finally, you should let your dentist adopt comprehensive treatment. In that way he or she cannot blame another dentist for doing a bad job.