Global Oral Health

Introduction
Atraumatic Restorative Treatment (ART) approach includes both prevention and treatment of dental caries. ART procedure is based on excavating and removing caries using hand instruments only and then restoring the tooth with an adhesive filling material (glass - ionomer).

This technique is simple enough to train non-dental personnel or primary health care workers. Unlike the conventional methods ART is non-threatening, does not need expensive electrically driven equipment and can be provided at low cost.

ART is suited in the field - for instance in schools, village halls or in health centers with minimum equipment and resources. All one needs are a flat surface for the patient, a stool for the operator and the necessary instruments and materials for ART which can be easily carried in a small bag. ART is a perfect alternative treatment apprach for dental caries in the developing countries where quite often teeth are left to decay to such an extent that they are extracted.

For more details about ART and its background, click Here! .............

The following set of pictures are from an ART Manual prepared by Drs Jo Frencken, Prathip Phantumvanit, Taco Pilot, Yupin Songpaisan and Evert van Amerongen and from Dr Yupin Songpaisan, Thailand.
Recommended work posture and position for the operator.
Recommended position for the operator and assistant. The patient lies on a flat surface.
Hand instruments needed for ART are: mouth mirror, explorer, a pair of tweezers, spoon excavator, hatchet or hoe and carver.
The area around the carious tooth to be treated is kept dry by placing cotton rolls. Then the cavity entrance is widened by using the hatchet or hoe. Now with the excavator caries is removed.
When all caries has been removed and the cavity cleaned and dried a dentine conditioner is applied on the cavity to improve the bonding of the filling material to the tooth.
The glass-ionomer filling material consists of powder and liquid which is mixed on a glass slab or a mixing pad. Mixing is completed in 20 - 30 seconds.
The mixture is inserted to the cavity with the flat end of the carver. The cavity is over filled to include remaining pits and fissures.
Rub some petrolium jelly on the gloved index finger and the filling material is pressed firmly with the finger on the tooth.
The excess material is being removed with a carver. The patient is not allowed to eat for at least 1 hour. Note no anaesthesia is used and no dental drills are needed during the whole procedure.