Amalgam and composite use in UK general dental practice in 2001

State-of-the-art techniques in operative dentistry: contemporary teaching of posterior composites in UK and Irish dental schools

“…In contrast, the placement of posterior composites and the practice of appropriate minimally invasive techniques have not continued to progress as quickly in general dental practice. [20][21][22] This is a cause for concern as large numbers of patients in the UK must be subjected on a daily basis to procedures which involve the unnecessary sacrifi ce of intact tooth tissue when receiving an amalgam rather than minimally invasive composite restorations. A similar sentiment was expressed in the recent review of the dental services provided by the NHS, in which the development of a further 'heavy metal generation' of patients was discouraged.…”

“…19 Contrary to this expert opinion, recent surveys on the use of restorative materials in posterior teeth in clinical practice indicate that within the UK amalgam still predominates over posterior composites. [20][21][22] The reasons for the apparent disconnect between clinical practice and expert opinion are considered to be multifactorial, including custom and practice being perpetuated, issues in respect of costs and fees, a failure of the profession at large to embrace minimally interventive dentistry, and the long lag time between changes in teaching and impact on clinical practice.…”

Challenges to teaching posterior composites in the United Kingdom and Ireland

“…17 While recent surveys 9,10 demonstrate that almost one-half of dental practitioners place composite in Class I and Class II cavities in permanent molar teeth, less than one-third of posterior restorations placed by dental students in the UK and Ireland are of composite resin. 13 In contrast, almost two-fi fths and one-half of posterior restorations placed in US 14 and Canadian 15 schools, respectively, are composite.…”

“…7,8 Surveys of general dental practice have found the increased use of composites in the restoration of Class I and II cavities, 1,9,10 with one-half of UK general dental practitioners placing composites in at least occlusal cavities in permanent molar teeth. 9 Posterior composites may therefore be viewed as an established element of everyday clinical practice and, as such, the competences of practitioners should extend to this approach to the restoration of teeth.…”

Teaching of direct posterior resin composite restorations in UK dental therapy training programmes

“…Consensus guidance from the mid-1990s recommended that the placement of composites in load-bearing posterior situations should be '…limited to the occlusal surfaces of premolars, and preferably those with limited occlusal function…' 7 Following, among other factors, improvement in the properties and handling characteristics of composite materials, the development of increasingly predictable bonding technologies, increased understanding of the ways in which adhesives and resins should be applied, increased demands from patients for aesthetic minimally invasive restorations, there has been a signifi cant increase in the number of posterior composites placed in general dental practice. [8][9][10] Surveys illustrate that one half of UK dentists place composites in the occlusal surfaces of premolar and permanent molar teeth, 11 with clinical evidence suggesting that the longevity of posterior composite restorations may now be found to match that of posterior amalgam restorations. 12,13 Furthermore, surveys of dental school training programmes demonstrate that the teaching of posterior composite restorations have increased by almost two-fold during the past ten years.…”