Contemporary dental practice in the UK in 2008: aspects of direct restorations, endodontics and bleaching

Use of lining materials under posterior resin composite restorations in the UK

“…However, only 20% reported that they typically used rubber dam when placing posterior resin composites. This is better than the 12% recorded in a study by Gilmour et al [28] and is comparable to the finding reported by Brunton et al [29] where 18% of dentists were found to be using rubber dam for direct posterior resin composite restorations. Gilbert et al [30] found that 63% of GDPs did not use rubber dam for any restorative procedure, whereas Lynch and McConnell [31] reported that 53% of GDPs never used a rubber dam for posterior resin composites.…”

Managing the phase-down of amalgam: part I. Educational and training issues

“…[22][23][24][25][26][27][28][29][30][31][32][33][34][35] In UK dental schools, undergraduate students have for a number of years gained, on average, more experience in the placement of posterior composite restorations than in the placement of dental amalgams (on average 55% posterior composite:45% amalgam), 28 with much of the remaining use of dental amalgam being the replacement of dental amalgams in older patients belonging to the 'heavy metal generation' . In contrast, surveys on aspects of general dental practice in the UK indicate that 59-75% of posterior restorations placed are of dental amalgam, 3 with amalgam still being widely used contrary to best available evidence, in the initial management of lesions of caries, creating yet another generation of dental amalgam patients. The reasons for this worrisome disconnect are primarily related to dental schools wishing to teach according to best evidence and the realities of working in primary dental care services, tempered, it is suggested, by a reluctance among some established practitioners to adopt new approaches to their practice of operative dentistry.…”

“…This has especially been the case in the United Kingdom where the use of dental amalgam has historically underpinned large elements of NHS dental care. 3,4 One of the consequences of this approach, which served great purpose for many years, is the 'heavy-metal generation' phenomenon. 5 This is a large number of ageing dentate patients who previously received many and extensive amalgam restorations, and who now have to live with the legacy of weakened teeth restored with what are increasingly viewed as unaesthetic, mechanically retained, metallic inserts.…”

What's new in dentine bonding?: universal adhesives

“…Finally, with regard to the clinical use of Universal Bonding Agents, it is worth adding that, while isolation with rubber dam is optimal (although not universally used 43 ) and moisture control (by whatever means) is essential, it may be considered that a further advantage is the reduced number of steps, and concomitant reduced technique sensitivity, of these new adhesive systems.…”