In this issue Dr Fahad Jamil outlines the use of anterior gold basket crowns among Amazonian communities and the biological implications that unconventional restorations can have on healthy teeth.

On a recent dental relief trip to the remote Amazonian communities Fahad witnessed these bold restorations for the first time and on questioning and treating patients it became clear these gold basket crowns are placed only for cosmetic purposes, as a signifier of wealth and status: 'I find it fascinating that the functional and aesthetic role of the dentition is regarded so differently amongst varying communities across the world.' However, unfortunate biological implications can result from such restorations, with poor construction and marginal adaptation coupled with poor oral hygiene and diet leading to caries and periodontal disease. Ultimately these teeth then require extraction.

Whilst most Western communities in the modern world opt for tooth-like restorations, modern trends for unwarranted prostheses such as 'grills' are a cause for concern, despite being removable, as aesthetic function is given prime importance without consideration to the hard and soft tissues of the oral cavity: 'Legislation and monitoring needs to be in place to ensure only trained dentists with appropriate restorative knowledge and skills are providing prostheses.'

Fahad chose to study dentistry due to its unique combination of medicine, technology and art. He is currently finishing a literature review on the biological benefits of the miswaak – a twig used as a toothbrush across the Middle East: 'It is important to have an understanding of the different cultural views on teeth as we live in a significantly multicultural society.'

Did you know? Outside of dentistry, Fahad is a keen amateur photographer. An example of his work can be seen below and can be found at www.fahadjamilphotography.com.