Minimally Invasive Dentistry
Minimally Invasive Dentistry is the application of "a systematic respect for the original tissue". This concept can be utilized throughout the practice of dentistry. The ultimate goal is to preserve tissue, or healthy tooth structure. This can be accomplished by preventing disease from occurring and intercepting its progress, and also by removing and replacing decayed tooth structure with as little healthy tissue loss as possible.
At Desoto Dental Services we prefer to utilize minimally invasive technique when indicated as the treatment of choice. Examples of minimally invasive procedures include:
- Remineralization of small decay rather than placement of fillings
- Antibacterial chlorhexidine mouthrinses
- Fluoride treatment
- SDF/SSKI treatment
- Small fillings combined with sealing any decay-free grooves in the chewing surface of a tooth
- Bonded restorations (composite resin fillings, inlays, and onlays) rather than placement of a crown. (Exception: if a tooth has had a root canal, a crown is the indicated restoration)
- Implant supported crowns instead of bridges.
Traditionally, tooth decay has been treated by numbing the tooth, drilling away decayed and sound enamel and dentin, and then replacing the lost tooth structure with a filling material. Over the years gold, silver amalgam, composite resin and ceramic materials have been used to fill teeth. Once a tooth has been filled, it will need re-treatment with new fillings, inlays, or crowns over the lifetime of the tooth. Sometimes the tooth will need to have a root canal, or even to be extracted.
In many cases, the damage to tooth structure is advanced to the degree that more aggressive treatments such as crowns, root canals, or even extractions are indicated. Our goal is to provide the most appropriate treatment for your specific needs.
Minimally Invasive Technologies In Use at Desoto Dental Services
- Digital Radiography: instant and enhanced images, exposes the patient to approximately 80 times less radiation than conventional x-rays.
- Intra-Oral Camera: instant and enhanced imaging for diagnosis and better patient understanding of the oral condition.
- Soft Tissue Laser: promotes healing by stimulating cell growth and regeneration, reducing bleeding and providing anti-inflammatory and biostimulatory effects.
- Implants: preserves tooth structure by eliminating bridges and controls/reduces bone loss following tooth extraction.
Silver Diamine Fluoride (SDF) and Super Saturated Potassium Iodide (SSKI)
Ideally, tooth decay is prevented through dental cleanings, effective brushing and flossing, and with the use of topical and systemic fluoride. Some teeth have deep grooves and fissures in the chewing surfaces that are so narrow at the bottom they cannot be cleaned completely by the bristles of a toothbrush. In preventive care, these teeth are often treated with pit and fissure sealants. There are instances when one of these teeth might have already started to decay in the groove or fissure before the tooth can be sealed. These teeth can be treated to arrest and even reverse the decay with a solution of silver diamine fluoride that is applied topically by the dentist on six month intervals, if indicated.
Recent studies show that this treatment of dental decay not only has arrested and reversed decay, but has rendered other surfaces of the treated tooth resistant to decay. In areas of deep decay, this same treatment can be used in conjunction with surgical treatment of decay to reduce the possibility of involvement of the dental pulp (the nerve), lessen the possibility of root canal therapy, and preserve tooth structure that would be removed in a more traditional treatment. This treatment causes the decay to darken as it arrests and heals, but the staining can be lightened with application of a super saturated potassium iodide solution immediately after rinsing the SDF from the tooth. In many cases of small pit and fissure decay, the groove is already stained to a dark color before it decayed.
This same treatment is indicated for hard to reach areas that have in the past required the removal of large amounts of healthy tooth structure, or the destruction and removal of existing crowns to be able to have access to the diseased areas of the tooth or teeth. Now, these areas can be treated non surgically without the destruction of health tooth or existing restorations. There are instances when a surgical approach is the only avenue of treatment, but there is a chance that a non-surgical treatment modality is the best choice for your tooth or teeth.
People should not be treated with SDF if they:
- Are allergic to silver
- Have painful sores or raw areas on the gums (i.e. ulcerative gingivitis) or anywhere in the oral cavity
- Have symptoms indicating the tooth needs root canal therapy
People should not be treated with SSKI if they:
- Are allergic to iodine
- Are pregnant or nursing
Teeth indicated for non-surgical treatment of dental caries:
- Pit and fussure decay without significant loss of enamel that can be sealed after the decay has been arrested and reversed
- Smooth surface decay on the tongue or cheek side of the tooth that can be sealed after the decay has been arrested and reversed
- Teeth with decay that cannot be accessed without destruction of significant amounts of healthy tooth or existing restorations, as evaluated by your dentist
Teeth that are indicated for minimally invasive treatment of dental caries through the use of SDI/SSKI in conjunction with a surgical approach to restoration of lost tooth structure:
- Teeth that will need a filling, inlay or crown to replace missing tooth structure that was lost to decay before the arrest and reversal of the caries lesion
- Teeth that have no symptoms indicating the tooth needs root canal therapy
Teeth that are not indicated for a non-surgical treatment of dental caries:
- Teeth with decay that has already involved the dental pulp
- Teeth that are no longer restorable because of destruction of tooth structure