causes the guiding surfaces on the working side to be separated. It is
important to identify such contacts as they are thought to cause high
lateral loads on teeth and a subsequent
predisposition to mechanical
failure of a restoration.
Any new restoration must be in harmony with the existing occlu-
sion if this is satisfactory. Where occlusal contacts are present that
may cause treatment difficulties or a predisposition to failure, then
steps should be taken to address this. For example,
a cavity margin
might be extended to avoid a contact at the potentially weak tooth-
restoration interface or a non-working side interference reduced or
eliminated (Chapter 2). Similarly, where
indirect restorations are
planned, these may be used to create a new occlusal relationship in
situations when the existing pattern is not satisfactory.
EXAMINATION OF THE DENTITION – CHARTING
A dental charting is a stylised record of the patient’s current dental
status. It is good clinical practice to record
the dental status at initial
presentation and subsequent follow-up appointments. A full dental
charting should be recorded in all patients’ notes, thus forming part
of the medico-legal record. It is not necessary to map the patient’s
restorations in detail on the charting, it is sufficient
to record the type
of restoration and/or cavity, not its exact dimensional extent. The
object of a dental chart is to record:
• All teeth present.
• Teeth that are absent or unerupted.
• Presence and condition of existing restorations (including partial
dentures and bridgework).
• Presence and extent of dental caries and other dental abnormalit-
ies, (e.g. non-carious tooth tissue loss,
fractures, developmental
defects and discoloration).
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