Restoring a tooth – is that »good medicine«?

Restoring a tooth is an everyday procedure in dentistry that has not, almost ever, been critically challenged. Such a challenge would touch upon the very core of dentistry. Our profession seldom critically reflects over »drilling and filling «. Others do: In an editorial in The Lancet in 2009 (1), the dental profession was described as follows: »Dentists have also taken little interest in oral health, preferring to treat rather than prevent oral disease«. One month later the British Dental Journal provoked its readers by asking if oral health and dentistry were compatible (2). And now we publish a series of articles that focuses particularly on »restoring a tooth«. Is this insane? No, it is not. Restoring or not restoring is a clinical decision that we make several times every day, and it has life-long consequences for the patient. Sometimes restoration can be a step in promoting oral health, as an adjunct to causal and preventive treatment. For the Nordic countries today, we do not agree with the statements in the mentioned editorials, since a focus on prevention and a trend not to restore early lesions have lead to a dramatic decline in caries prevalence in our region. Restoration of caries lesions is still an important treatment procedure and non-amalgam materials have made it possible to provide less invasive restorative care that should increase the mechanical durability of the tooth-restoration complex. The separate papers in this series will follow this line of reasoning.