Operative dentistry involves the diagnosis, treatment, and prognosis of dental defects without full coverage restorations. The field has evolved from mainly extractions in the 17th century to modern minimally invasive techniques using bonding and composite materials. Factors like increased fluoride exposure have reduced caries rates, though it remains common, and more teeth are being retained in older populations. The future of operative dentistry includes addressing the needs of an aging population and further improvements to materials and techniques to allow for more conservative treatments.

2. DEFINITION
“ Operative dentistry is the art and science of
the diagnosis ,treatment and prognosis of the defects
of teeth that do not require full coverage restorations
for correction. Such treatment should result in the
restoration of proper tooth form, function and
esthetics while maintaining the physiologic integrity of
the teeth in harmonious relationship with the adjacent
hard and soft tissues, all of which should enhance the
general health and welfare of the patient ”

3. History
17th century “Barber-
dentists” sent from
England to US.(tooth
extractions mainly)
Dental caries=
“gangrene-like
disease”
Treatment of
defective part of
tooth by removal of
cavity &replacement
of missing tooth
structure by “filling”
with some type of
material.
1840 ,Baltimore
college of dental
surgery.
Amalgam as
restorative material.
1867,First
university-affiliated
dental program,
Harvard university.

4. G.V Black related
clinical practice of
dentistry to a
scientific basis.
1999,Periodic
examinations,
bite-wing
radiographs and
prophylactic
procedures
Charles E Woodbury
E.K.Wedelstaedt,
Waldon I Ferrier &
George Hollenback
Louis Pasteur discovered
role of microorganisms in
disease.
Modern operative
dentistry includes
diagnosis
&treatment of many
problems not just
caries.
Terms “Tooth
preparation”
&“restoration”.

5.  INDICATIONS:
 Caries
 Malformed, discolored, nonesthetic or
fractured teeth &
 Restoration ,replacement or repair.

6.  Considerations
 Infection control.
 Thorough examination of oral and systemic health of
patient.
 A diagnosis of dental problem that recognizes
interaction of affected area with other body tissues.
 A treatment plan that has the potential to return the
affected area to a state of health and function,
enhancing the overall health and well-being of the
patient.

7.  An understanding of the material to be used to
restore the affected area,including a realization of
the material’s limitations and techniques involved
in using it.
 An understanding of the oral environment into
which the restoration will be placed.
 An appreciation for and knowledge of correct
dental anatomy.
 An understanding of the effect of the operative
procedure on other dental treatments.

8.  Conservative Approach
• Earlier concept of “extension for prevention.”
• Increased knowledge of prevention methods,
advanced clinical techniques, and improved
restorative materials have provided a more
conservative approach to the restoration of teeth.

9.  More conservative approaches are available for
(1) many typical restorative procedures (Classes I,
II, III, IV, and V)
(2) diastema closure procedures
(3) esthetic or functional correction of malformed,
discolored, or fractured teeth; and
(4) actual replacement of teeth.

10. The primary
results of conservative treatment are
retention of more intact
tooth structure and less trauma to the
pulp tissue and
contiguous soft tissue.

11. Dynamics of Operative Dentistry
• The development of the high-speed
handpiece played a dramatic role in the more
conservative and efficient removal of tooth
structure for restorative procedures.

12. • Mechanical bonding by etching enamel and dentin
and use of bonding systems have led to the
development of many new composite restorative
materials and conservative restorative bonding
techniques.
• Benefits of sealants are becoming more widely
accepted for the prevention of pit-and-fissure
caries.
• Increased knowledge about the carious process
and the beneficial effects of multiple fluoride
applications has resulted in a decrease in caries
incidence.

13. • Increased research on biomaterials has led to the
introduction of vastly improved dental materials.
• All of the above mentioned factors have played an
important role in the development of operative
dentistry.
• Ultimate result is improved oral health for all
populations.

14.  DEMOGRAPHICS
248
394
0
50
100
150
200
250
300
350
400
450
US POPULATION (increase by 146
million)
1990
2050

15. • Percentage of older adults in the
population and also life expectancy will
increase substantially in the future.
• Emphasis will shift from the needs of
young to concerns and demands of
middle-aged individuals & older adults.

16.  Economic Factors
• With more discretionary income and more
health care benefits for the adult segment
of society, the demand for future dental
services should increase.

17.  General and Dental Health of
the U.S. Population
• The general health of the U.S. population is good.
• Americans generally have good dental health.
• Incidence of caries has decreased ;primarily due
to increased exposure to fluoride.
• Fluoridation of community water systems began in
Grand Rapids, Michigan, in 1945.
• Caries remains the most common chronic
childhood disease.

18. • Missing teeth : In last several decades, there has
been a steady reduction in edentulism and
numbers of teeth lost per person.
• Edentulism and the number of teeth present are
strongly influenced by age
100
56
0
20
40
60
80
100
120
Dentulous individuals
Age 18-
24yrs
Age >75 yrs

19. • Periodontal Status: periodontal Attachment
loss (number of affected people and
severity) increased with age.
• Gingival recession also increased with age.
• Oral Cancer: Oral and pharyngeal cancer is
the sixth most common neoplastic disease.

20.  Dental Manpower
• The number of total “active private
practitioners” is expected to increase from
156,921 in 2002 to 172,097 in 2020.
• There will be fewer dentists treating more
patients who will have retained more teeth.

21.  Projected Need for Operative
Dentistry
• Increased need of operative dentistry in
future :
i. restorations for teeth with new carious
lesions;
ii. restorations for teeth with root caries;
iii. restorations to replace existing, faulty
restorations; and
iv. restorations to enhance the esthetic
appearance of patients.

22.  Public’s Perception of Dentistry
• The public’s perception of dentistry is another
factor that will influence whether the increased
numbers of teeth and increased need for
operative services will be converted to increased
demand.

23.  Patient Visits
• The number of dental visits has increased in
the past several years.
• Recent surveys shows that New older adults
and future older adults not only will possess
positive perceptions about dentistry and
dental health, but also will have the
economic means to secure the dental care
they need.

24. • Research in operative dentistry is now occurring in
many fields.
• Use of lasers in dentistry may lead to a new
mechanism for welding dental alloys or altering tooth
structure in tooth preparation.
• Improvements in composites, adhesive
systems, castable ceramics, and computer-
generated restorations could result in significant
decrease in the use of metal alloy systems in
operative dentistry.
• Efforts also are being made to develop an anticaries
vaccine.

25. • The future of operative dentistry is
good.
• The emphasis of the profession will
shift to care for the senior adult
segment of the population and also to
nonsurgical treatments for caries.