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MINIMALLY INVASIVE DENTISTRY

December 1st, 2011

We have advanced in the diagnostics of dentistry to be able to provide procedures to prevent tooth decay and also to recognize and treat decay at a very early stage.  For some time we have stressed the need for sealants on the molar teeth of most children and some adults.These are placed into the deep but otherwise healthy grooves on the biting surface where decay is most likely to start.  The grooves are protected from plaque growth in areas that would be impossible to keep clean.
Previously, when decay had started in the grooves, tooth structure would be removed so a filling could be placed.  Some schools taught to make these preparations quite large since it was felt that this would prevent future decay.  Instead, we learned that it weakened the tooth.  So today we remove as little tooth structure as possible and bond in a combination of a very small filling and sealant.  This is the essence of minimally invasive dentistry.
But what about the smooth surfaces on the sides or even between the teeth.  There are no grooves here to retain sealant.  There is a new system available for these early cavities called “ICON”.  The Icon system consists of a very powerful acid with special devices that will dissolve the decay and some of the minerals and then deliver an acrylic resin that penetrates the softened area to harden and seal it.  There is no drilling and no need for local anesthetic (no needles!)
Think of tooth enamel as a sponge like framework with minerals in the spaces providing the strength and hardness.  In early tooth decay, bacterial acids dissolve the minerals out of the framework leaving behind just the softer sponge-like matrix.  If left this way the matrix will break apart and a cavity will form.  The Icon resin will penetrate the intact matrix and restore its strength and resistance to further decay.  It can be placed in lesions on the smooth surfaces and even between teeth where early spots are detected on x-ray examination.

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