Elsevier

Dental Abstracts

Volume 59, Issue 4, July–August 2014, Pages e83-e84
Dental Abstracts

Hands On
Interim therapeutic restorations via the virtual dental home

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Background

The virtual dental home (VDH) system developed by the Pacific Center for Special Care at the University of the Pacific is delivering oral health care to underserved and vulnerable populations. The VDH system uses geographically distributed, telehealth-enabled teams that work in community locations beyond the traditional dental care delivery system. It is designed to address significant access challenges and health disparities in California. It redefines the use of the term “dental home” to

ITR Placement in the VDH System

The placement of ITRs follows a technique that is more commonly called atraumatic restorative treatment (ART), but emphasizes the provisional nature of these restorations. Allied dental professionals in the VDH system have been trained to place ITRs under the general supervision of dentists. The dentist determines whether a tooth needs a specific ITR and instructs the allied dental professional to place it. Placement is accomplished without the dentist being present in the treatment site.

The

Evidence Supporting the Technique

Although the ART technique has been widely used in third-world countries often under less-than-optimal conditions, comparisons with conventional dental restorative techniques indicate that the outcomes are comparable or the ART restorations are superior. With greater understanding of the caries disease process, specifically, that it is caused by an ecological shift in the oral biofilm from beneficial to acidogenic bacterial species, resulting in demineralization of enamel and dentin and active

Discussion

The VDH system employs dentists who supervise allied dental professionals in telehealth connected teams. This method provides dental health to traditionally underserved people in California. ITRs are placed according to the principles developed in ART, which has proved well suited for situations that are less than optimal. Caries lesions are arrested, the patient has less fear and anxiety, and dentists can monitor the tooth and make further decisions for care over time for patients who

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Glassman P, Subar P, Budenz AW: Managing caries in virtual dental homes using interim therapeutic restorations. Calif Dent Assoc J 41:745-752, 2013

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