ATRAUMATIC RESTORATION TREATMENT

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