In this issue of our blog, I’ll be discussing “minimally invasive dentistry”. In bygone days, dental decay was detected by using a sharp probe (“explorer”) to find “holes” or “cavities”. Xrays showed decay between teeth where the probe couldn’t reach. Then, after administering a local anesthesia (“novacaine”), a rotary instrument (the “drill”) was used to remove the decayed portion of the tooth until a clean hole was created—kinda like cutting out a bad spot from an apple. Most commonly, silver amalgam ( a mixture of silver, mercury and small amounts of other metals) was used to fill the holes. Since the silver filling is not “attached” to the tooth, merely wedged in, the tooth is weaker than it was before treatment.
With minimally invasive techniques, we use a diagnostic laser to peer into the grooves and pits on the biting surfaces of teeth after they are cleaned. It has been shown the the sharp probe can actually damage a weakened tooth, so our probes are not super-sharp. When the laser tells us decay is present, we use either a fine stream of abrasive particles or another type of laser to remove it. Sometimes we need to use a slow speed “drill” to finish the preparation before we repair the “hole” by bonding tooth-colored composite resin (no mercury) to the surrounding tooth. Most of the time this approach does not require anesthesia. The bonded filling actually restores strength to the decay-weakened tooth.
In summary, minimally invasive techniques utilize modern technology such as diagnostic lasers to help us decide when disease exists so we can intervene before much damage occurs, and treatment lasers as well as air abrasion instruments to cleanly excise the germs, their toxins as well as compromised tooth structure. The tooth remains strong, looks great and best of all, there’s usually no pain.