Dr. Brian Saby's Dental Blog

Once a dentist has finished a comprehensive dental examination, he must come up with a treatment plan to help meet the patient’s dental goals.  These usually are:  Comfort, function, stability and esthetics.  More plainly: Look good, feel good, chew well and last a long time. 

To reach these goals, we often divide dental treatment in to two phases.  Phase one treatment involves the treatment of active disease.  Phase two treatment involves repair of damage caused by the previous disease.  In some cases, phase one treatment will be all that is required, in other situations, phase one and phase two treatment can be accomplished at the same time.  Sometimes, phase one treatment must be completed prior to phase two treatment.

Phase one treatment…stopping disease.

Creating healthy gums.  This usually involves gum treatment.  The goal is to have healthy gums that do not bleed.  This usually means a trip to the dental hygienist for a deep cleaning.  If the gums are still inflamed after initial gum therapy, laser gum therapy, chemical gum therapy or surgical gum therapy may be needed.

Creating healthy teeth.  This involves fixing any cavities that have formed.  These can be new cavities, or cavities under and around old fillings.  Worn teeth must be examined and the cause of the wear determined.  If it looks like the wear is due to grinding the bite must be stabilized.  If the damage is caused by acids, the source of the acids that dissolve the teeth must be found and eliminated or reduced if possible. 

 Creating a healthy bite.  This part of dental treatment is not as familiar to the general public.  In order to function properly and to reduce wear, the bite must be checked to ensure that the lower teeth move into the upper teeth in a way that maximizes the biting forces and reduces the strain on the muscles and jaw joint.  Many times the phase one treatment for this problem may be an appliance that is worn at night to help relax the muscles and prevent wear.  Phase one bite therapy may involve balancing the bite by selective tooth adjustment.

 After the disease is halted phase one treatment is either completed, or the final part of the phase one treatment may be to move the teeth.  This is done to allow the bite to be as good as it can be.  Teeth are moved with braces. 

Following phase one dentistry, the teeth and gums should be in a state where they are not infected or inflamed and the teeth are where they need to be. At this point, all treatment is either completed and only regular check ups and maintenance is required or it is time to start restoring the teeth to their ideal form and function…phase two treatment. 

I will discuss more about phase two dentistry in our next segment.