When individuals require extensive dental treatment, dentists typically have several options, including fillings, crowns, bridges, root canal treatments, and dental implants. While there is substantial knowledge about the lifespan of each treatment individually, estimating how well an entire mouth of restored teeth will perform over the years has remained challenging.
My latest research, published in the Journal of Dentistry, introduces an innovative concept, the Restorative Dental Prognosis Index (RDPI). Instead of predicting exact outcomes for patients, the RDPI provides a structured approach for dentists to assess the long-term outlook for the entire mouth.
Howe, M.S., Richards, D. “Conceptual Development of a Restorative Dental Prognosis Index: A Proof-of-Concept Framework Integrating Survival Evidence and Restorability Assessment.” J Dent 173 (2026) 106849. https://doi.org/10.1016/j.jdent.2026.106849
How the RDPI Works
The process is straightforward: each restored tooth is assigned a simple rating—good, uncertain, or poor—based on its overall condition and relevant research regarding the longevity of similar treatments. By evaluating all teeth collectively, dentists can create a clearer picture of a patient’s overall dental health compared to the traditional method of analysing each tooth in isolation.
The Impact of Individual Teeth
The study emphasises that even if most restorations are likely to last many years, the presence of one or two weaker teeth can significantly affect the long-term success of the entire mouth. This insight encourages more informed discussions between dentists and patients about the benefits, risks, and likely maintenance needs associated with different treatment options.
Moving Towards Evidence-Based Discussions
We clarify that the RDPI is not intended to serve as a crystal ball predicting the future with absolute certainty. Rather, it represents a significant step forward in developing a more consistent, evidence-based methodology for discussing dental prognosis.
If future research confirms its efficacy, the RDPI could empower dentists to explain treatment options more clearly, promote shared decision-making with patients, and facilitate the creation of treatment plans that are technically successful, realistic, affordable, and built to last.
Thoughts on Life and Dentistry 