Dental Tribune United Kingdom Edition

T he high standard of oral healthcare and the evolu- tion and change within everyday dentistry has never before been so rapid as it is in dentistry today. The rise of more complex dental treatments and techniques and the recent inno- vations of products and thera- pies have introduced many pro- fessionals to higher standards in practice. However, what is becoming apparent is that en- dodontics is becoming more dif- ficult as the population ages and this sector is driving the change within the profession. Today’s society has led to an increase in patient’s expectations to maintain their natural teeth. Patients no longer expect or are resigned to having dentures as their parents and grandparents did, they want their own teeth and they are more inclined to keep up with regular mainte- nance and more advanced treat- ments to ensure this happens. Just having a tooth out is no longer an option as it can lead to further ramifications, which are more difficult to deal with. As the patients age they may have specific health issues which may make them more prone to dental health problems. This may be as a result of medication; however, the Root Canal Treatment (RCT) itself may be harder to perform. There is sometimes a need for more extensive treatment to rescue a tooth after many years of service, and more patients are opting for RCT to retain the natural tooth and to salvage large and complex restorations. A patient that presents with se- vere toothache due to dental decay would have had limited options years ago, with extrac- tion being the most common treatment. However, with the increased prognosis and likeli- hood of a successful treatment, patients are much more likely to opt for this treatment rather than extraction. Treating an older patient becomes more complex and challenging due to several fac- tors including: • The reduction of space in the pulp • Sclerosis of canals • Treatment area may be through crowns and bridges • Elderly patients may not be able to tolerate longer chair times The medical history of a pa- tient can also make RCT a pref- erable treatment. For example, a patient undergoing cancer treatment or radiotherapy, or taking bisphosphonates and anticoagulants may avoid ex- traction, as RCT would have less knock on effects to their gen- eral health. The patient’s age and health status are of course consid- ered before dental treatment; however, another factor that must be explored is the medi- cations they are taking. Anti- depressants, diuretics and dia- betic medication may lead to Age and Endodontics Michael Sultan discusses how and when to treat ageing patients effectively with endodontics ‘Today’s society has led to an increase in patient’s expecta- tions to maintain their natural teeth’ January 24-30, 201124 United Kingdom EditionClinical