Recall and Oral Health Maintenance.

Abstract

The aim of this chapter is to discuss current evidence and clinical protocols for recall and maintenance in patients who have undergone non-invasive and/or invasive treatment for erosive tooth wear. There is a paucity of research and evidence for some of the suggested protocols, and some sections are based on clinical experience. Recall for patients who have undergone non-invasive treatment is either for behavioural change and/or monitoring of progression of tooth wear. Behaviour change needs to be patient centred and holistic, with an individualised plan. Recall is essential to assess adherence to any behavioural change plans and advice, as well as any change in the patient's risk category. If the patient has active signs or symptoms associated with erosive tooth wear progression, such as dentine hypersensitivity, symptomatic reflux or an active eating disorder, it is prudent to review the patient after 3 months. If the recall visit is mainly cantered around assessing progression of the wear, periods between 1 and 3 years depending on the presumed aetiology of the patient are appropriate with the current methods of assessing progression, including intraoral scans and various indices. The main aims are to identify the risks, reduce the risks and ensure the progression of wear is stabilised. In cases where invasive treatment has been carried out, the non-invasive recall and maintenance still apply. In addition, the recall visits entail repair or replacement of restorations. In general, the most minimally invasive approach that is accepted by the patients should be attempted, such as monitoring stained margins, repair of restorations to prolong the lifespan of the restoration or in some cases progression to more invasive restorations, all depending on the patient's wishes and the goal of improving quality of life.