Is prevention more important now than ever?

Discussion on how to achieve a preventive mindset among clinicians has been taking place for, it seems, decades. It is the ultimate in minimally invasive dentistry, which has been much talked about/written about since the COVID-19 crisis caused a rethink on dental operative procedures. Why, you may ask, do dental schools have vast areas set aside for restorative dentistry, when there is nothing resembling a total preventive clinic? Hume, in 1992, described this phenomenon as a ‘restorative tiger’ that needed ‘taming and turning’.¹ And, I am sure that, had GV Black (probably best known for his principles of cavity preparation) been alive today, he would have agreed with such comments, given his statement in 1896 ‘the day is surely coming when we will be practising preventive rather than reparative dentistry’.

At a time when there has been much head-scratching regarding aerosol production (well discussed in the last issue in the paper by Prof Samaranayake²), the alternative approach, already proposed by me and my co-authors two issues back³ (seems like a lifetime!), is to utilize procedures which don't involve an aerosol, but the alternative proposal, which is to concentrate even more on prevention. Have all our patients been taught an effective method of plaque control? Orthodontists, I know, will not proceed with treatment until their prospective patient undertakes a session of Oral Health Instruction. Why should patients undergoing operative treatment for caries be different? They should have the same instruction.