Minimally Invasive Dentistry to Manage Dental Caries
Minimally invasive dentistry is dramatically impacting the way dentists practice. Scientific breakthroughs and new understandings for dental caries have produced highly effective, evidence-based protocols for risk assessment and management of this disease. Treatment has shifted from being repair-based to consisting of detection, risk assessment, and healing of early lesions. At the Updates in Contemporary Dentistry Meeting in Twin Cities, Dr. Ron Kaminer discussed new minimally invasive technologies and treatments.
?We live in a world where an average patient knows more about dentistry than ever before because of the Internet,? he said. ?And it isn?t a bad thing. It helps us to have an informed discussion with our patients about new techniques.?
Caries Detection and Treatment
Dr. Kaminer stressed early caries detection, and he defined minimally invasive treatment as performing the least amount of treatment to accomplish the task while conserving the most amount of dental anatomic structures.
Dr. Kaminer described the destruction of calcified tissues observed with dental caries and cavitations. Dr Kaminer attributed the increase in caries to people drinking more soda and sports drinks. Dr. Kaminer explained that by testing saliva, you can get more information to know how best to treat patients.
Dr. Kaminer also mentioned caries diagnostic tools that use LED detection to quantify caries activity. By bridging with digital X-ray software, this helps the dentist determine whether remineralization is an option or if a restoration is required. Dr. Kaminer told the audience that this technology is also a marketing tool that helps dentists distinguish their practice from others in their communities.
For situations where a restoration is needed, Dr. Kaminer said in an interview that glass ionomer cements combined with composite restorations were good treatment options. According to Dr. Kaminer, they offer unique advantages over flowables and are able to bond to enamel, dentin, and composite. They also minimize leakage in the occlusal and proximal surfaces.
Dr. Kaminer on Caries Detection Products
In an interview, Dr. Kaminer said he used the CariScreen susceptibility test from Oral Biotech as a tool for screening patients with a higher risk for caries. He also cited Air Techniques? Spectra, which is an LED detection device that projects blue light at 405 nm.? Light at this wavelength stimulates porphyrins to fluoresce red, while healthy enamel fluoresces green. He went as far as to call the Spectra ?Doppler radar for caries detection. The Spectra bridges with digital x-ray software, and it allows recording of images in the file.
Dr. Kaminer said it is also important to involve the patient in the caries prevention, and advocate using products that can combat tooth and gum decay. He highlighted the Church & Dwight products, which include a number of formulas that include fluoride for caries protection. He noted that these products alter the PH levels in the mouth, providing a poor environment for cariogenic causing bacteria.