Mind the Neighbor teeth: 5 rules to follow
Here are 5 rules to follow if you care about preserving neighbor teeth. Taking care of the teeth close to the one(s) on which we focus our therapy is common sense and dental good manners.
In all of our procedures we use rotating tools; however, as much careful and delicate we try to be, the rotation of the tips itself makes it likely that we somehow touch the neighboring tooth.
It is also important to remember that every time a cavity is opened, we have a special access to the proximal tooth, and that’s unique chance you don’t want to miss!
Here are 5 golden rules for You:
– Do not touch neighboring teeth with rotary instruments
– Teflon protection: don’t etch the neighboring teeth
– Polish existing restorations
– Seal your old restorations
– Remember an open cavity is a big opportunity
…and if it happens, polish them! It is important to leave the proximal wall, that will be in contact with the new restoration smooth, to avoid plaque retention and to help the patient in flossing at home.
You can use wedges that carry an integrated matrix barrier.
Discs with different abrasiveness, can be really useful to remove the scratches on the tooth surface and to round the crest.
It helps to not etch neighboring teeth. It is better to use a teflon tape piece not too thin: 0,20 mm thickness is very good.
This is an easy and fast procedure that can really give a second life to old restorations.
It can also help you achieve a better interproximal contact point if we have a correct shape of existing restoration(s).
When a cavity is opened, a direct view of the composite restoration is available. With a thin explorer like LM explorer 11f or 12f, you can check the margins and the composite surface.
If there a micro leackage or are bubbles or surface defects are present, just refresh the surface by sandblasting or with a bur, and do the adhesion again to fill them with new composite.
This direct vision helps a lot in detecting lesions and in treating them easily respecting crests and healthy enamel.
We, as dentists, tend to be really focused on a single tooth we are treating; while it is a good sign that we are concentrated on it, we always must keep an wide view on our patient’s mouths to take the opportunities that certain specific clinical situations give us.
The care of neighboring teeth is one of that moments, and can be a key point to obtain mini invasive treatment, respecting the patient teeth and saving time.
Chiodera G, Pavolucci G. 50 shades of teflon – Part 1. styleitaliano.org 2016
Chiodera G. Back to basics: mind the wedge. styleitaliano.org 2017