Restoring Enamel Integrity the Drill-Free Way

Ask most dentists how often they see early lesions, and many would struggle to give a precise answer.

“Drill and fill” has long been the default response to incipient lesions—areas of demineralization that go deep into the enamel, even up to the dentino-enamel junction, where traditional preventative solutions cannot reach. Visible on radiographs,

noted in charts, but without a targeted treatment designed to address them, these lesions exist in a clinical blind spot.

That’s the gap Aspen Dental set out to address when it partnered with vVARDIS last year to bring Curodont Repair Fluoride Plus into its practices.

“We’re always looking for innovation,” Rute Ramalho, DDS, MS, MBA, Vice President of Hygiene Strategy & Operations at The Aspen Group, said. “Curodont really got our attention because, historically, when a patient comes in with a cavity and you do a filling, that’s just the start of something. A few years later, you may need to replace it. You may need a crown. You may need an implant down the road. If you can intervene early in the disease process, when the tooth surface has still not broken down, you can keep that tooth structure longer. And that is life-changing for the patient, who is not only going to save time and money, but their health as well.”

Closing a Long-Standing Treatment Gap

For decades, clinicians have largely operated with two broad options when managing caries: traditional prevention and invasive restoration. Patients could receive fluoride and oral hygiene recommendations to help prevent disease, or, once a lesion progressed, restorative treatment.

According to Dr. Haley Abivardi, co-CEO of vVARDIS, there has been no solution available between those two endpoints to effectively treat the early stages of caries without artificial filling materials.

“The last innovation in dentistry for caries management was 80 years ago with fluoride,” Dr. Abivardi said. “So, in dentistry, you had prevention where you could only superficially remineralize early-stage caries with fluoride varnish or other preventive products. And then for bigger cavities, you had crowns, root canals, bigger fillings. But for early-stage cavities, there was a treatment gap, because if you drill them you take too much healthy tooth structure away and it is a half-hour of expensive chair time.

“Curodont is closing this gap,” she said. “It’s the first time you have a medical approach that addresses early-stage cavities—not with artificial filling materials, but by enabling the restoration of fluoride-enhanced hydroxyapatite crystals throughout the depth of the lesions.”

That concept resonated with Aspen Dental's philosophy around minimally invasive dentistry and preserving natural tooth structure whenever possible.

A Slow Start—Then Growing Confidence

At first, some clinicians within the Aspen Dental network questioned whether the product could truly stop the progression of early lesions and enable the restoration of lost minerals into the depth of the lesions, or whether it would ultimately prove little different from traditional preventive therapies. “Let’s be honest,” Dr. Ramalho said. “Some dentists were skeptical. ‘Does this really do what it says it does or is it just another product where we can only treat the surface of the enamel?'”

To support implementation, Aspen Dental and vVARDIS developed an extensive education strategy focused on three groups: dentists, hygienists, and patient consultants. Doctors received training on the science and clinical evidence behind the technology; hygienists learned how to integrate treatment into daily workflows; and front-office teams were taught how to communicate its benefits to patients.

Beyond the scientific evidence and cases from peers, the turning point came when clinicians began seeing results firsthand.

“When the patients come back a few months later and you do another x-ray, you see the lack of progression and even reduction in the size of the lesion,” Dr. Ramalho said. “That really made an impression with our clinicians. You see a slow start and then it’s like, ‘No, this really works. This is amazing.’”

When AI Entered the Picture

Aspen Dental's integration of Videa's AI technology has become a significant driver of treatment acceptance. While the software helps identify early lesions, its greatest impact may be in making those lesions visible to patients.

“The bad guy is not the dentist telling you, ‘Oh, you have cavities,’” Dr. Abivardi said. “The patient says, ‘I don’t feel anything—are you really telling the truth?’ But when you have the AI, the bad guy is AI. Even a child can see, ‘What are these red dots?’”

Practices using AI alongside Curodont, she noted, have experienced dramatically higher treatment acceptance.

Dr. Ramalho said hygienists within the Aspen Dental network frequently point to AI as one of the most effective tools for helping patients understand why intervention makes sense before symptoms appear.

Expanding What's Possible in Hygiene

Another factor driving adoption is how easily the treatment fits into existing workflows. The application can be completed in just a few minutes, often during a routine hygiene appointment, allowing patients to receive care the same day the lesion is identified. The simplicity of the procedure has also expanded the role hygienists can play in managing early disease while freeing dentists to focus on more complex procedures, Dr. Ramalho noted.

Moving Toward a New Standard

One year into the partnership, both organizations see a broader shift occurring across the profession.

DSOs, academic institutions, and clinicians are increasingly embracing non-invasive approaches to caries management. For Dr. Ramalho, one of the strongest indicators of that shift is what happens when dentists begin tracking the lesions they’ve historically placed on a watch list or drilled prematurely.

“I think dentists mostly don’t notice exactly how many early-stage caries they see in a day,” she said. “They don’t count it. Then they say, ‘Oh my God, these are all the opportunities I’ve had. Look at what I could have treated with Curodont. Look how many patients I could have helped.’ When they start looking at the data, they really get bought in.”

For Dr. Abivardi, the ultimate measure of success is seeing patients become proactive participants in their own care—coming into the practice before disease progresses and asking whether something can be done now rather than later.

“There really has been a change of mindset with the patients. Before, many were afraid to come in because of the drill and would only come when they were in pain. Now, they want to come in and see if they can still be treated drill-free and needle free. And that is a dream for dentists who really want to improve the oral health of their patients.”