‘No-drill’ dentistry stops tooth decay
A University of Sydney study has revealed that tooth decay (dental caries) can be stopped, reversed and prevented without the need for the traditional ‘fill and drill’ approach that has dominated dental care for decades.
The results of the seven-year study, published in Community Dentistry and Oral Epidemiology, found that the need for fillings was reduced by 30-50% through preventive oral care.
Researchers said that for a long time it was believed that tooth decay was a rapidly progressive phenomenon and the best way to manage it was to identify early decay and remove it immediately. After removing the decay, the affected tooth is then restored with a filling. However, 50 years of research has shown that decay is not always progressive and develops more slowly than previously believed. For example, it takes an average of four to eight years for decay to progress from the tooth’s outer layer (enamel) to the inner layer (dentine).
The team in Sydney developed the Caries Management System (CMS) – a set of protocols that cover assessment of decay risk, interpretation of dental x-rays, and specific treatment of early decay (decay that is not yet a cavity).
The CMS involves four aspects:
1. Application of high concentration fluoride varnish by dentists to early decay.
2. Attention to home tooth brushing skills.
3. Restriction of foods containing added sugar.
4. Risk-specific monitoring.
The CMS was tested on high-risk patients with great success, said the researchers, who concluded that a tooth should only be drilled and filled where an actual cavity is already evident. Tests of the CMS in general dental practices confirmed that after seven years, decay risk was substantially reduced among the CMS patients, and their need for fillings was reduced by 30-50% compared to the control group.