Minimally Invasive Dentistry and Silver Diamine Fluoride by Dr Róisín Boyle
Minimally invasive dentistry is a a very popular model of providing modern day dental care. It aims to preserve the form, aesthetics and function of the natural dentition for as long as possible by first controlling the disease and then restoring the dentition in the most conservative way. It is based on a wide range of scientific research and is evidence based. By preserving more of the natural tooth structure, we can improve the long term prognosis of the tooth. By using excellent isolation techniques and precise detection of the decayed parts of the teeth we can be very precise in removing defective tooth structure. This allows us to restore the tooth using advanced adhesive techniques which can mean less tooth cutting. We are at a very exciting time in dentistry with many more conservative options available to treat dental decay.
Silver Diamine Fluoride is a very useful material which can be very beneficial in managing both sensitive teeth and decay. This can be especially useful in baby teeth when co-operation may not be ideal for treatment. When applied to the tooth it can slow the progression of the tooth decay and has an 80% success rate. It can harden the softened dentine and make it more resistant to acid and abrasion. It is a fast, easy and comfortable treatment. It can give an immediate relief for sensitivity and kills the microorganisms that cause the cavities. A repeat application gives the best result. The decayed area will turn black after treatment but not the healthy tooth substance. This can then be covered with a filling if required. This can reduce the risk of early tooth loss in children, reducing the need for general anaesthetics and also maintain the space for the adult teeth so that there is reduced risk of needing orthodontic treatment when the permanent teeth erupt.
Early detection of tooth decay is vital to employ the most conservative techniques, this is why we recommend all adults and children should attend regularly, usually every 6months, for an examination. Even, in the case of deep decay in a tooth we can sometimes use techniques which can reduce the chances of the tooth requiring a root canal treatment.
The pictures above show an example of a very broken down tooth restored using advanced adhesive dentistry techniques in one visit. This was completed using restorative composite.
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