Mr Steve Bonsor in practice

The vast majority of dental care provided for the general population in the United Kingdom (and indeed many other countries) is carried out in general dental practice either under the auspices of the National Health Service or under private contract.  Most treatment provided in this environment comes under the umbrella of restorative dentistry although, by definition, other dental disciplines are also included.  Care received in general dental practice is widely considered to be more representative of “real life” dentistry.  Unfortunately, very little research is conducted in this environment with potential barriers such as lack of expertise, skills, knowledge, time and associated costs being cited.

Very often practitioners work in the same practice for many years so building up a wealth of data.  This offers great potential to analyse such outcomes as the survival of restorations including their modes of failure, performance of materials and success or otherwise of treatment modalities.  Such examples of research projects which have been carried in general dental practice within the group are the survival of bonded (sealed) dental amalgam restorations compared with conventional dental amalgam restorations over a ten year period studying some 5700 teeth.  This study also examined the reason for failure of the restorations included in both groups.  Other such projects have looked to determine the survival of root treated teeth which had bacterial photodynamic therapy used as an adjunct to the disinfection of the root canal system.  Although this study included all teeth endodontically treated in a fifteen year period, survival of these teeth was reported at the ten year mark as a sufficient sample size was present at that time frame to make the results statistically meaningful. This study is to be revisited this year with the intention of being able to report survival rates at the fifteen year mark.

In the recent past, there has been a change in practice of providing more conservative options for the definitive restoration of endodontically treated teeth by means of cuspal coverage onlays instead of full crowns.  This has been due to developments in restorative materials with newer products having become more commonplace.  One such example is lithium disilicate due to its excellent aesthetics and high strength.  Many more of these types of restorations would be placed in general dental practice than a University or dental hospital environment and so this lends itself to glean such information more quickly to inform prescribing patterns and evidence based best practice.

Furthermore, this domain lends itself to collaboration with other University departments such as the Institute of Medical Sciences, Chemistry and the School of Engineering.  Links have already been forged with common educational projects and common courses and it is hoped that with time, collaborative research can be undertaken with colleagues in these departments.