Atraumatic restorative treatment

A dental treatment approach focusing on minimal intervention

Atraumatic Restorative Treatment (ART) is a minimally invasive approach to managing dental caries. It emphasizes the preservation of tooth structure and the use of hand instruments to remove decayed tissue, followed by the placement of a restorative material. This technique is particularly beneficial in settings with limited access to dental care and resources.

History

The concept of Atraumatic Restorative Treatment was developed in the 1980s as a response to the need for a more accessible and less invasive method of treating dental caries, especially in low-resource settings. The technique was pioneered by Jo E. Frencken and his colleagues, who sought to provide effective dental care without the need for electricity or advanced dental equipment.

Principles

ART is based on the principles of minimal intervention dentistry, which focuses on the preservation of healthy tooth structure and the prevention of further decay. The key components of ART include:

• Removal of Decay: Using hand instruments, such as excavators, to gently remove softened, decayed tooth tissue.
• Restoration: Filling the cavity with an adhesive restorative material, typically glass ionomer cement, which bonds chemically to the tooth and releases fluoride to help prevent further decay.
• Prevention: Emphasizing oral hygiene education and the use of fluoride to prevent new carious lesions.

Procedure

The ART procedure involves several steps:

1. Diagnosis: Identifying carious lesions that are suitable for ART. 2. Isolation: Keeping the tooth dry and free from saliva using cotton rolls or other isolation techniques. 3. Caries Removal: Using hand instruments to remove decayed tissue while preserving as much healthy tooth structure as possible. 4. Cavity Cleaning: Ensuring the cavity is clean and ready for restoration. 5. Restoration Placement: Filling the cavity with glass ionomer cement, which is then shaped and allowed to set.

Atraumatic Restorative Treatment in practice

Advantages

ART offers several advantages, particularly in resource-limited settings:

• No Need for Electricity: The use of hand instruments eliminates the need for electrically powered dental equipment.
• Cost-Effective: ART is less expensive than traditional restorative techniques, making it accessible to a wider population.
• Minimally Invasive: Preserves more of the natural tooth structure compared to conventional methods.
• Fluoride Release: The use of glass ionomer cement provides a continuous release of fluoride, aiding in the prevention of further decay.

Limitations

While ART is effective in many situations, it has some limitations:

• Limited to Small Lesions: ART is most effective for small to medium-sized carious lesions.
• Durability: The longevity of ART restorations may be less than that of conventional restorations, particularly in high-stress areas.
• Operator Skill: Successful ART requires skilled practitioners who are adept at using hand instruments.

Applications

ART is widely used in community dental health programs, particularly in developing countries where access to dental care is limited. It is also employed in school-based dental programs and in situations where traditional dental care is not feasible.

Related pages

• Dental caries
• Minimal intervention dentistry
• Glass ionomer cement
• Preventive dentistry