The whine of the dentist's handpiece is perhaps one of the most recognizable sounds in everyday life, but we may be hearing that sound less often if methods proposed by a new study are implemented. Atraumatic restorative treatment or "no-drill dentistry" represents a shift in the way clinicians think about the prevention and treatment of early tooth decay.

Studies for the past 50 years have shown that tooth decay is not always progressive. In fact, even progressive decay develops more slowly than most dentists think, taking 4-8 years to progress from the enamel to the dentin. Among those who visit the dentist for regular cleanings, this is plenty of time to attempt intervention before resorting to fillings, which are sometimes performed preemptively to prevent a decayed surface from breaking up into cavities.

So what does atraumatic restoration entail? In the case of a patient with early stages of decay, the treatment approach would be as follows:

  • First, high-concentration fluoride varnish is applied to the sites of early decay after thorough cleaning.
  • Second, the patient is educated on brushing skills and the benefits of ultrasonic toothbrushes.
  • Third, restrictions are imposed on between-meal snacks and beverages containing added sugar.
  • Finally, the patient is coached on how to monitor the sites for further decay.

Researchers at the University of Sydney conducted a study testing atraumatic restorative treatments in an effort aimed at reducing early childhood caries. The study found that children treated according to these methods were both less likely to need fillings and less likely to be referred for specialist care. Furthermore, practitioners were able to provide treatment for more children in the atraumatic group, owing to the time-efficient nature of the techniques.

Atraumatic restoration methods should not be confused with allowing classic, "hole-in-the-tooth" cavities to go untreated. These cavities are treated the old-fashioned way: with a handpiece and filling material of choice. However, even these cavities are eligible for atraumatic methods. New inventions such as the "cold plasma" brush have been proven to clean out cavities more efficiently than a drill, without consuming tooth matter. Furthermore, filling materials adhere better to tooth surfaces prepared with the plasma tool over conventional drilling.

As dental technology continues to grow and develop, it is likely that our methods will trend toward more elegant and less invasive solutions for dental complaints, benefiting both practitioners and high-fear patients.

Sources:

 

Arrow, P., & Klobas, E. (2015). Minimum intervention dentistry approach to managing early childhood caries: A randomized control trial. Community Dent Oral Epidemiol Community Dentistry and Oral Epidemiology, 511-520.

News Bureau. Retrieved December 15, 2015, from http://munews.missouri.edu/news-releases/2011/1220-“painless”-plasma-brush-is-becoming-reality-in-dentistry-mu-engineers-say/

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The information contained in this, or any case study post in Incisor should never be considered a proper replacement for necessary training and/or education regarding adult oral conscious sedation. Regulations regarding sedation vary by state. This is an educational and informational piece. DOCS Education accepts no liability whatsoever for any damages resulting from any direct or indirect recipient's use of or failure to use any of the information contained herein. DOCS Education would be happy to answer any questions or concerns mailed to us at 106 Lenora Street, Seattle, WA 98121. Please print a copy of this posting and include it with your question or request.

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The information contained in this, or any case study post in Incisor, should never be considered a proper replacement for necessary training and/or education regarding adult oral conscious sedation. Regulations regarding sedation vary by state. This is an educational and informational piece. DOCS Education accepts no liability whatsoever for any damages resulting from any direct or indirect recipient's use of or failure to use any of the information contained herein. DOCS Education would be happy to answer any questions or concerns mailed to us at 3250 Airport Way S, Suite 701 | Seattle, WA 98134. Please print a copy of this posting and include it with your question or request.
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