There's a New "No Drill" Approach to Treating Cavities

For many people, a trip to the dentist means the sound of drills, cavity fillings and a high anxiety level. Now, research is showing that a “no-drill” approach can help keep less people from needing to have cavities filled in the first place.

Findings from a seven-year study conducted in Australia and published in the journal Community Dentistry and Oral Epidemiology, show that the need for fillings fell 30 to 50 percent when patients followed a preventive care plan after the initial signs of tooth decay were detected.

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Associate professor at the University of Sydney and the study’s lead author, Wendell Evans, said in a university news release, “It’s unnecessary for patients to have fillings because they’re not required in many cases of dental decay. 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). That is plenty of time for the decay to be detected and treated before it becomes a cavity and requires a filling.”

This “no-drill” approach, developed by Evans and his team, involves four components including the application of a high-concentration fluoride varnish to the site of the early tooth decay; attention to tooth brushing skills at home; no snacks or drinks with added sugar between meals; and regular monitoring.

When tested on patients at several general dentistry offices, Evans reported that “early decay could be stopped and reversed, and that the need for drilling and filling was reduced dramatically.” However, drills aren’t going away forever—when deeper cavities create an “actual hole in the tooth,” they may be necessary.

Atlanta cosmetic dentist Ronald Goldstein, DDS, says that his practice, among many others, has been using laser diagnostic tests for dental decay for many years, which has helped eliminate the need for drilling and filling. “This has been 95 percent effective and even the 5 percent of teeth that did not turn out to have cavities could be easily sealed and protected,” he adds. “We have a very effective laser to not only prepare a cavity, but also to numb the tooth so the patient does not need a drill.”

X-ray and diagnostic tests can also show areas that are in the beginning stages of decay, which can allow dentists to remineralize the areas with topical solutions, special toothpastes and good home care.

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