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The Atraumatic Restorative Treatment
(A.R.T.) is a procedure based on excavating carious
cavities in teeth using hand instruments only and restoring
them with an adhesive filling material (glass ionomer). This
procedure was originally developed because millions of people
in less industrialized countries and special groups like refugees
and people living in deprived communities are unable to obtain
dental care. Their teeth generally decay until removal is
required. These people have not benefited from the developments
that have brought about improved oral health in the industrialized
world. The absence of electricity and the traditional idea
that restorative dental care requires electrically driven
equipment are the main reasons underlying this situation.
In contrast the A.R.T. approach enables treatment of cavities
in teeth of people residing in areas where electricity is
not available, or where the community cannot afford expensive
dental equipment.
The A.R.T. technique provides
the oral health worker with a tool that supports the concept
"Teeth for Life". Removing carious tooth tissue
with hand instruments alone and restoring the cavity with
glass ionomer will conserve as much tooth structure as possible
and prevent further decay.
In developed countries, the ART Technique has found a place
in the modern surgery. A patient with multiple carious lesions
is treated with the ART Technique and the carious process
stabilized before a more definitive restoration is placed.
Dentists have found that this technique is useful for nervous
patients who are scared of the drill, and restorative procedures
are accomplished using hand instrumentation only. ART is also
found to be useful in treating patients with medical or physical
disability. The procedure may be carried out in the patient's
home or in the hospital. Use of the ART Technique is also
useful in introducing children to dental care and helps to
overcome any fears of traditional dental treatment.
The two main principles of ART are:
¨ Removing carious tooth tissue using hand instruments
only
¨ Restoring the cavity with a glass ionomer
The reasons for using hand instruments
rather than electric driven handpieces are:
¨ it makes restorative care accessible to all population
groups
¨ the use of a biological approach, which requires minimal
cavity preparation that conserves sound tooth tissues and
causes less trauma to the teeth
¨ the low cost of hand instruments compared to electrically
driven dental equipment
¨ the limitation of pain that reduces the need for local
anesthesia to a minimum and reduces psychological trauma to
patients
¨ simplified infection control; hand instruments can be
easily cleaned and sterilized after every patient
The reasons for using glass ionomers
¨ As the glass ionomer chemically bonds to both enamel
and dentin, the need to cut sound tooth tissue to prepare
the cavity is reduced
¨ fluoride is released from the restoration to prevent
and arrest caries
¨ glass ionomers are biocompatible, does not cause any
irritation to pulp and gingiva and has a coefficient of thermal
expansion similar to tooth structure
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