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.
In my practice, I 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 surronding 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.
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Cosmetic Dentistry Tip:
Brushing alone is usually not enough to ensure that a person won’t develop periodontal disease. Since 40% of a tooth’s surface is not reachable by tooth brushing, some sort of interproximal cleaning device should be used on a regular basis. Floss, Stimudents and small interproximal brushe , and all work well. It doesn’t matter as much which method is chosen, but what counts is that one of these is effectively used on a regular basis.
Regular and frequent professional cleaning at the dentist also help, since they remove any accumulations of plaque and tarter that have been missed by a patient by their daily homecare regime. Also a patients home care can be checked at frequent cleaning visits and the hygienist will encourage them to do better. Human nature being what it is, patients often perform their best home care immediately before and after their checkups.
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Friday. February 4, 2012