Emerging Ethical Issues in Restorative Dentistry

Abstract

This article reviews some of the merging ethical issues in restorative dentistry. This is a branch of healthcare concerned with quality of life, since retention of functioning teeth is important in allowing a healthy diet to be consumed. Yet the supply of dentists is such that, in many of the world's poorest countries, extraction is the only viable option for treating tooth decay. Available repair materials present various ethical problems. Silver amalgam is being phased out in much of the world, because of environmental concerns with mercury, yet it is cheap and reliable. Alternatives have been developed, influenced by the West's preoccupation with appearance, yet these materials are difficult to place and are less durable than amalgam. These concerns lead to significant ethical problems, which are explored in this article. It concludes by proposing a way to deal with the emerging ethical problems.

Progress in eradicating amalgam from restorative dentistry

“…Dental amalgam is currently the most widely used restorative material in dentistry, with an estimated 60% of restorations in advanced countries being based on this type of material 11 . If we include restorations from the poorer countries of the world, this proportion almost certainly rises 12 .…”

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“…Various studies have shown that glass ionomer cements (GICs) 1,2 have potential bioactivity, adhesion to hard tissues and also reduce the formation of plaque by Streptococcus mutans strains. [3][4][5][6][7][8][9][10][11][12] The antibacterial activity of glass ionomer cements (GIC) is mostly attributed to their fluoride and other ions release for secondary caries inhibiting effect, which has been already confirmed in vitro with lower demineralization depths of the glass ionomer groups adjacent to the dental hard tissue. [13][14][15][16][17][18][19] Thus, these cements are expected to actively control microbial biofilm formation, while biofilms modulate the release of fluoride from GICs.…”