NEW! A COMOX VALLEY STUDY CLUB FOR DENTISTS

In spring 2024 Dr. Walford opened a  study club in the Comox Valley. 4 practitioners are participating so far and it is open for two more members. It is Dr. Walford’s 6th study club, following a ten year career speaking to dental societies across Canada.

The study club is accredited  for continuing education with the BC College of Oral Health Practitioners.

The program covers direct restorations in adhesive dentistry, and adhesive anterior and posterior bridges, which, compared to mainstream,  are stronger, more versatile, often more attractive, more conservative, and founded in better science.

The cost per year will be approximately $2000. Meetings are held 6 times a year in the Comox Valley at the offices of the members or on line with Zoom. It is didactic and face-to-face, which gives the opportunity to discuss the issues of the members that are meaningful to them.

Posterior composites are still hampered by  confusing and unsuccessful beginnings in the 1990s- postoperative pain, rapid re-decay,  early fracture and poor interproximal contacts. Indirect anterior bridges (the Maryland Bridge) came loose and promoted decay while being unsightly due to grey shine through from Day 1. Posterior adhesive designs were placed in  hopeful sea of under-preparation concepts and failed both patient and practitioners early. Many practitioners still find that post-operative sensitivity, staining, short lifespan and disappointing restorations  are a problem, and are accustomed to explaining them as stepping stones to real-dentistry- full crowns.

At this point in the materials science, this widespread dysfunction is due to the way they are employed. Well-executed adhesive restorations, using the right resins, bonding agents and preparation designs have the capacity to serve the patient completely effectively and save teeth that otherwise end up being extracted.

Below is an example of what can be accomplished in a single appointment, rejuvenating the broken, worn, sharp and disfiguring lower anterior teeth of an older male. We can be confident that years of untroubled service will ensue. The irregularities  left in the incisal edges belong in a real face, although perfect symmetry is attainable if that is the goal of treatment .

This work was done without anesthetic and covers dentin by a minimum of 0.5 mm,  enough for ten years of service life for this elderly patient.

 

 

 

 

 

In case you are wondering, how were  the incisal edged lengthened, a buttress of composite was carried down onto the lingual surface to support and strengthen the cantilevered part of the restoration, i.e re-lengthened  past the remaining tooth structure. The method? The lingual surface was  sandblasted inside a Tofflemire matrix band, generating optimum adhesion despite no preparation with burs. Then the restoration was placed inside a fresh Tofflemire band. With this method long and trouble-free service is routine.  Yes it is overcontoured on the lingual, but not grossly. The patient quickly adjusts and accepts it. The success of this  approach has been validated over 20 years of placement in many hundreds of cases, many of them adverse. As well, members of past study clubs taught by Dr Walford have echoed the same outcomes.

The resin used was Tokuyama Estelite Sigma, shade A3.5, with a flexural strength of 130 MPa. It is metameric enough to blend with the host tooth  but still sufficiently opaque to be used as a single increment without grey shine through from behind.

In posterior restorations, restorations such as this 3-surface molar are normal. The photos below show a 15 year old example of what can be achieved. This case continues beautifully without wear, broken contact, discoloration, pulpal injury, stain accumulation or recurrent decay.

     

Dr. Walford has been teaching adhesive dentistry for over 20 years, mentoring hands-on study clubs, demonstrating procedures before large audiences at the Pacific Dental Conferences on four occasions, 2012-2018, and lecturing to dental societies across Canada. He also has published a number of articles in Oral Health Magazine, the largest dental publication in Canada.

He  invented and now markets a simple yet powerfully effective custom matrix system called the Bandbender to make large posterior composite restorations successful. 

Dr Walford  was recognized as a Fellow of the Canadian Academy of Restorative Dentistry CARDP.ca in 2010.

He completed training in cast gold in 2003 with Dr Richard Tucker, who was  a great inspiration as a mentor and dentist. You will see Dr. Tucker’s influence in the smooth flowing outline and  consistent chamfer lingual margin of this composite preparation on an upper left first molar.

An increased range of dental conditions that are served with these methods bring  interest and  satisfaction to the practitioner. More treatment can be provided on a lower budget for the patient. Being well bonded following clear enamel axioms, they stand up without the attendant risk of cusp fracture as seen in amalgam. Today, with higher fees in the fee guide,  they are cost-efficient for the practice, if one learns to be clear-minded, efficient, and effective with the various methods in this website.

The techniques  at the heart of the program are based in science, selectivity in the materials chosen, finesse, discipline, discretion in their application, attention to efficiency so that time is not wasted, and observations from 49 years of practice.

To join, please contact Dr. Walford at 250 218 9238 (Cell/Text), or  pwalford@telus.net

While this website is still under construction, it can be subscribed to by contacting pwalford@telus.net