In an interview with TechSci Research, Mr. Paulo Varela said that more and more people have now started visiting their dentists because of aesthetic reasons, the desire to have white and straight teeth is advertised everywhere.

TechSci Research- How is your work related to restorative dentistry? 

Paulo- My work is about implantology. Usually, what I do is not direct restorative dentistry of the natural teeth. Rather, I place implants and make the rehabilitation of that implant. I don’t work on natural teeth. I work on edentulous patients making oral rehabilitations on the patients. I also did research to evaluate the action of low power lasers penetrating collagen membranes, the goal was to study light penetration in this type of materials.

TechSci Research- What, according to you, are the major barriers to the adoption of restorative procedures or major challenges that are hindering the growth of restorative dentistry industry?

Paulo- The economic issue is the major obstruction for restorative dentistry. Mackenback et al. (2008) in a comparative study, concluded that Portugal, compared to other European countries, has high levels of inequality in terms of education, influencing the access to oral care. Compared to other EU countries, Portugal has high rates of dental caries, periodontic problems and high percentages of edentulous people, without the presence of natural teeth in oral cavity. In Portugal exists the SNS, (Nacional Health Service), that take care of health in general, but not oral health directly. The Portuguese Government gives a voucher of 35 euros, (max. number of 11 vouchers), for specific people, like, children and young people up to 18 years of age who attend public schools. Pregnant women followed by SNS, elderly beneficiaries of the Solidarity Supplement, patients with AIDS infection and patients with high risk of oral cancer. Convened dentists must make about 5 treatments in each patient. Services are generally of particular nature, with limited initiatives carried out by government to encourage population in oral hygiene care. In France, under the Assurance Maladie, the government pays for the regular dentistry treatments, about 70% of their price conditions. In Portugal, we can also have private insurances. The private insurance pays part or promote a discount over the treatment. We also have some sub health systems where patients pay a small part of the treatment. The regular population must pay their dental treatments. Another hindrance for restorative dentistry is that the number of dentists is quite high. In Portugal, it’s nearly three times higher than the total dentists that are required. Young dentists ending their courses, have high theoretical knowledge, but a severe lack of clinical practice. How we know clinical practice as it is fundamental in dentistry. If clinical practice fails, patient treatments may be at risk.

TechSci Research- Is there any development or changes happening in the restorative dentistry industry that you feel is worth sharing or are you foreseeing any major developments happening in the industry over the years?

Paulo- The trend of restorative dentistry is the digitization of dentistry especially, orthodontics implantology and prosthesis. Moreover, more and more people have now started visiting their dentists because of aesthetic reasons, the desire to have white and straight teeth is advertised everywhere. There is a lot of progress in digital dentistry. But all of digitalization raise the total price of the procedures.

TechSci Research- If we talk about the restorative dentistry market, was there any major change due to the COVID-19 pandemic crisis?

Paulo- During COVID, in Portugal, we were obliged to stop completely. 2020 was very difficult, 2021 was better. This year, the problem is not COVID but the economy. At present time, COVID is not a problem but the Russia-Ukraine war. The war has led to major financial problems because the prices of food, electricity and gasoline have seen a peak. This has made people focusing on what is better for them and food and housing are the principal reasons.

TechSci Research- Is the current Russia-Ukraine War crisis having any kind of impact on the restorative dentistry industry across the European countries?

Paulo- According to my knowledge and what some experts say, the price for titanium has increased significantly. It is possible that in median term the price for professionals will increase. Titanium price now, is higher than the price in December 2020. At present, the implants are being manufactured with the titanium bought last year. When there will be a need for more titanium, I’m sure it will be much higher as Russia is one of the biggest exporters of titanium. We are buying large portion of titanium from Russia. Some European brands of implants may buy titanium in the market and maybe some of this titanium comes from Russia. Another issue is the increasing price of transportation, consequently, the prices will be higher no matter where the titanium is from.

TechSci Research- According to you, what do the people of Portugal or overall Europe prefer to go to dental hospitals or dental clinics (the standalone ones)?

Paulo- Usually, people go to clinics. But in Portugal, there is a huge number of private hospitals offering dental practices. Currently, people are going to big structures as they believe they are better quality treatment, and private hospitals have all the health subsystems and insurances. This is a big problem for small private clinics, when people see a big hospital, they feel that they can have better treatment comparing to a small clinic.

TechSci Research- According to you, what are the factors that have significantly increased the demand for restorative dentistry?

Paulo- People realized that oral health is very important for their wellbeing, another factor is the aesthetic, beautiful teeth represent beautiful and healthy people men and women, globally.

TechSci Research- Could you brief us about the impact on medical tourism?

Paulo- Medical tourism has increased, especially in Turkey. Turkey offers the treatment at very cheap rates. Turkey is making a lot of procedures, such as hair procedures, skin procedures (Botox) and even for breast implants. The only challenge is the quality of treatments and professionals.

TechSci Research- When we talk about dental restorations, generally on which type of teeth are these procedures performed and why? (Anterior (Incisors & Canines) or Posterior (Molars & Pre-molars))

Paulo- Although posterior teeth require more restorations, but people want dental restorations to be performed on anterior teeth. I have patients with no molars, but they want restorations of anterior ones.

TechSci Research- In terms of the direct and indirect dental restoration procedures, which are being more commonly performed and why? (if you can quantify in terms of percentages)

Paulo- The indirect ones are being more performed as it is cheaper, easier, and more comfortable. We just need to make a scan in patient’s mouth; the machine makes the piece and teeth is placed in the mouth of patient. It’s very convenient and the errors are not so big. Indirect simple restorations may just contribute to about 10%-20% in general dentistry. Talking about the global scenario, direct ones are more. For instance, in France, the government pays for the direct simple restorations and not for the indirect ones. Only crowns they pay. The price of lab onlays and inlays are very high compared with direct restorations made directly in the mouth of the patients.

TechSci Research- There are different components used in a dental restoration procedure like implants restorative materials, prosthetics, etc. Which according to you forms the most integral part?

Paulo- Implants, Veneers and orthodontics are in very high demand right now.

TechSci Research- Which country across the Europe witnesses the highest number of dental restoration procedures performed?

Paulo- As per my understanding, restorative dentistry is a basic procedure, and more population will call for more resto- rations. Furthermore, the growing geriatric population of the country also effects the demand for restorative dentistry activities.

TechSci Research- Who are the major companies operating in the global restorative dentistry market? Any, European company that you know which is making key developments.

Paulo- We have Kulzer from Germany, VOCO GmbH, and 3M Co. In Europe, Germany and EUA are the major investor in dentistry, outside Europe we can consider that Brazil invests a lot in all kinds of material related to all areas of dentistry.

Authors: Manvi Suri, Shaurya Singh, Himanshu Saxena 

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