The practice of minimally invasive dentistry is based on scientific advancements and evidence-based approaches. Conventional methods often treat dental problems as they occur, while minimally invasive methods focus on preventative measures to slow progression to intercept the need for invasive treatments. This method of dentistry requires early intervention from dental providers and cooperation from patients to become successful.

Conventional Dentistry vs. Minimally Invasive Dentistry

 Conventional dentistry has a major emphasis placed on removing decayed hard and soft tissues and replacing them with a dental filling material. These procedures often involve drilling away decayed tooth structure and filling it with an alternative material. In severe cases, tooth extractions with forceps are necessary to remove the decayed tooth. As a result, local anesthetic injections are required to numb the areas, often leaving the patients numb for several hours following the procedure. The injections can be painful and leave the areas susceptible to injury from biting forcefully on soft or hard tissues while the areas remain numb. Extractions and other soft tissue procedures can cause excessive bleeding and require an adequate amount of time for the healing process to complete.

Minimally invasive dentistry focuses on detecting susceptible areas and using preventative methods that treat dental problems before they become severe. For example, if a dental provider detects an incipient lesion, intervention would be recommended to the patient immediately. Recent scientific advancements have led to new treatments to remineralize enamel and prevent progression of carious lesions. There are several innovative dental materials and equipment used that provide patients with options to revitalize existing hard tissue or remove decay while preserving the surrounding area. Minimally invasive dentistry provides patients with options that do not require anesthesia, thus providing a more comfortable and less invasive treatment.

Preventative Treatments 

●      Sealants

●      Fluoride Varnish

●      Silver Diamine Fluoride

Sealants are used to fill in pits and fissures that are vulnerable to decay due to deep grooves that cause plaque traps. The sealant material is filled into the grooves and fissures and cured onto the tooth surface. In addition, many sealant materials contain fluoride, which is gradually released to remineralize the tooth surface.

Fluoride varnish is a highly concentrated fluoride applied to the teeth that promotes remineralization by attaching to the calcium and phosphate minerals present, forming fluorapatite to repair enamel. The varnish is primarily used for incipient lesions to enable remineralization of caries penetrating enamel.

Silver diamine fluoride is composed of fluoride and silver minerals. The silver minerals have antibacterial properties that kill existing bacteria cells. Furthermore, the fluoride minerals attach to the calcium and phosphate minerals present, which form fluorapatite and aid in enamel remineralization. Lastly, the phosphate minerals in the dentin layer bond with the silver minerals to create silver phosphate, which hardens onto the tooth surface. Silver diamine fluoride arrests further decay of existing caries that extend into dentin and promotes remineralization to prevent recurrent decay. As a result, a permanent dark discoloration is left behind on the tooth surface.

However, if aesthetics are not a concern, this method is especially useful on patients that have ailments that hinder the use of drills and/or anesthesia and is essentially pain-free. 

Operative Treatments

●      Air Abrasion

●      Dental Lasers

The goal for minimally invasive dentistry is to remove as little soft or hard tissue as possible. To achieve this, dental lasers and air abrasion equipment are used. These tools are able to provide precise cuts, which enable the dentist to remove only the amount necessary. 

Air abrasion is utilized to remove decayed areas on the outer layer of enamel by sending pulses containing a stream of abrasive particles to the tooth surface. These tools are also used to remove minor existing fillings or to prepare teeth for crowns.

This enables the dentist to preserve the surrounding tooth structure, removing only the amount necessary. These tools are very quiet and associated with very little discomfort when used if the areas are isolated properly.

Dental lasers are used for hard tissue and soft tissue removal, treating decay and gingival tissues, respectively. These procedures typically do not require anesthesia or cause bleeding, thus creating a more comfortable experience for the patient. Most dental lasers on the market today can be costly and time-consuming, thus many dental offices do not use them. Of those offices that do use dental lasers in their practice, they are mainly used for gingival tissue reconstruction. However, many are hopeful the advancements in dentistry will provide alternative options that are more user-friendly in the near future.

The FDA currently has only approved dental lasers for hard and soft tissue removal, but many are hopeful they will also be cleared for cavity prevention soon. The University of California at San Francisco School of Dentistry has studied the use of dental lasers for many decades. Through collaboration with laser physicists, they are working toward creating a

short-pulsed carbon dioxide laser that heats the top layer of enamel and changes the composition, resulting in a harder layer. The laser is designed to heat the enamel layer, changing the carbonated hydroxyapatite to hydroxyapatite, which is less vulnerable to decay. John Featherstone, PhD, dean of UCSF School of Dentistry, explains:

”Whenever you put a filling inside a tooth, you weaken it… What lasers can do now is to protect and save the natural integrity of the tooth, and that has been a dream of many of us.”

Benefits of Minimally Invasive Dentistry

The benefits of minimally invasive dentistry are plentiful, and the techniques used can be especially beneficial for those who experience dental anxiety or have pre-existing conditions limiting the use of anesthesia. In addition, there is minimal to no bleeding during the procedures, which stimulates faster healing time. While there are limitations regarding the extent to which these treatments can be completed, the advancements continue to push forward the practice of minimally invasive dentistry.

These evidence-based approaches are designed to detect early signs of abnoormal dental conditions and provide preventative treatment methods to preserve natural teeth.

Author Bio

Kayla Makowski is a registered dental hygienist with a passion for providing education on the importance of oral health. She is committed to staying up to date on the latest advancements in dentistry through continuing education courses. Kayla finds joy in being a mom to her son, and in her free time she cherishes spending time with family.