Lawrence M. Spindel DDS Minimally invasive dentistry Dentist New York, NY
By Lawrence M. Spindel DDS Friday, March 2, 2007
Minimally invasive dentistry is a term that refers to a relatively new trend in dentistry involving an attempt by dentists to minimize the size of the preps used to restore teeth. Traditionally, when dentists were taught to restore teeth using silver fillings, preparations had to be a certain depth for the filling to work. Now dentists are using bonded composite to restore teeth and the preparations don’t always have to be as deep as they would have to be for the placement of silver fillings. Also, there is an increasing appreciation among dentists that our preparations can weaken teeth in the long run and lead to teeth breaking or cracking. Because of this ,whenever possible, dentists preserve tooth structure and only remove the amount of tooth that is needed to rid the tooth of decay and allow the placement of a relatively long lasting restoration.
Sometimes a tooth has a small discoloration and just lightly planing the surface of a tooth with a fine diamond can remove it. This process is called micro abrasion and may not even require the placement of a filling.
In my practice, I also see a lot of instances where teeth are missing some of their enamel due to wear. Where ever dentin is exposed to the oral environment, it tends to erode and further undermine the surrounding enamel. Over time, this accelerates the loss of surrounding enamel and tooth structure. As a preventive measure I often make very shallow retentive preparations in this dentin (depth of .5 to.75 mm) and place bonded composite restorations to protect the previously exposed dentin. These tend to minimize the errosion that will then take place. The bonded surface now slowly erode, not the dentin.
In order to accomplish these restorations very small diameter dental burs(drill bits) are used. Also, my tools are very narrow so I can place the composite into tiny spaces. I find it also helpful to wear glasses with high powered magnification so that I am better able to accomplish what otherwise would be extremely difficult with normal 20 -20 vision.
