Did you ever think that certain dental treatment procedures can cause problems? If you are wondering what this is about, then you need to know about “Iatrogenic Factors” in dentistry. Any faults in dental restorations and prostheses are referred to as iatrogenic factors. These are common causes of gum infection and destruction. Inadequate dental procedures may also injure the structures of the gums.
Six characteristics of restorations (fillings) and prostheses are important from the viewpoint of gum health.
Margins of restorations
The type of filling that is done for a cavity between two teeth is called a type 2 cavity filling in technical terms. These types of fillings are difficult to do and have a huge impact on the health of the gums. Any filling must confine to the contours of the tooth to serve the purpose of chewing. When there is an excess filled into the area, it is called an overhanging margin. These overhanging margins encourage plaque accumulation and alter the local microflora by increasing the growth of disease causing bacteria. The rough surfaces of the fillings also encourage plaque accumulation.
Restorations that do not confirm to the occlusal patterns of the mouth cause disharmonies and affect the periodontal health.
Removable partial dentures favour plaque accumulation especially if they cover the gums. The prostheses themselves encourage the growth of disease causing bacteria. Improperly made dentures cause loosening of adjacent supporting teeth and periodontal pockets. Wearing dentures at night may further increase the accumulation of plaque.
The shape and size of the crowns and restorations has to be maintained for the good health of the surrounding gums. Improper proximal contacts, inadequate inter proximal embrasures and failure to reproduce the protective anatomy of occlusal margins lead to food impaction.
Materials themselves do not cause injury to the periodontal structures. Plaque formed on the margins is similar to that formed on the adjacent teeth.
The injudicious use of rubber dam, matrix bands, discs and excessively vigorous condensing of filling materials can lacerate and injure the gums. These injuries heal with in sometime, but is an unnecessary discomfort. This may cause acute symptoms of pain and sensitivity to percussion.