Minimally Invasive Options

A thoughtful dental treatment plan is essential for ensuring optimal oral health. It should encompass all available treatment options, from preventive care like routine cleanings to more invasive procedures such as extractions, root canals, and implants. Among these options, minimally invasive dentistry (MID) plays a crucial role in preserving the integrity of natural tooth structure while effectively addressing dental issues.

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The Spectrum of Dental Treatments

Preventive measures are the first line of defense in maintaining oral health. Regular cleanings and examinations help catch potential problems early, reducing the need for more invasive treatments later on.

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Minimally Invasive Dentistry (MID)

Minimally invasive dentistry emphasizes techniques that preserve as much healthy tooth structure as possible. This approach utilizes advanced methods to treat dental diseases while minimizing discomfort. In many cases, MID should be considered and offered before more invasive procedures like extractions and drilling. Examples of MID include:

• Silver Diamine Fluoride (SDF): Ideal for treating both primary and permanent teeth, especially when cavities are not extensive. It can also be effective on root surfaces, particularly in seniors.

• Glass Ionomer Sealants: These sealants can protect against decay without drilling, making them a suitable option for patients at risk.

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More Invasive Procedures

In some cases, more extensive treatments are necessary. These include drilling, extractions, root canals, and dental implants. While these procedures may be unavoidable, MID should be prioritized when feasible to maintain tooth structure and minimize patient discomfort and potential complications associated with more invasive treatment options.

Making informed decisions about your dental care is vital to maintaining and keeping your teeth. This requires understanding all treatment options available to you. Here’s how to approach it:

• Discuss Alternatives: Always inquire about alternative treatment options. Many dental issues can be addressed through various methods, and knowing your choices allows you to select the best path for you and your family.

• Weigh Risks and Benefits: When presented with different options, consider the risks and benefits associated with each. This customized approach helps ensure that the treatment plan aligns with your specific dental needs and preferences.

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Requesting Silver Diamine Fluoride

Silver diamine fluoride is a valuable tool in minimally invasive dentistry. If your provider has not offered you SDF in your treatment plan, you may need to initiate the discussion. Connecting the tooth numbers with your request for SDF will help you have a more productive discussion with your provider as you collaborate on a treatment plan. The image and explanations below provide some framework for your collaboration with the provider.

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SDF is particularly helpful in the following applications:

Anterior Teeth (Incisors): A trained provider can treat incisors directly with a brush-on application of the FDA-approved solution.  Your incisors are shown on the tooth chart as tooth numbers 7, 8, 9, 10, 23, 24, 25, and 26.

Canines : Canines are sometimes referred to as “eye teeth.” Your canines are shown on the tooth chart as tooth numbers 6, 11, 22, and 27.

Bicuspids:  Bicuspids are sometimes referred to as “premolars.” Treatment involves using a wedge interproximally (between two teeth), followed by brush-on or floss application to reach these areas. Your premolars are shown on the tooth chart as tooth numbers 4, 5, 12, 13, 20, 21, 28, and 29.

Molars: Providing SDF for molars is similar to the treatment for bicuspids. Your molars are shown on the tooth chart as tooth numbers 2, 3, 14, 15, 18, 19, 30, and 31.

Wisdom Teeth: Many patients have wisdom teeth extracted as a young adult due to inadequate room in the jaw. If you still have your wisdom teeth, you can find wisdom teeth under teeth numbers 1, 16, 17, and 32 on the tooth chart.

Root Surfaces: Sometimes teeth break leaving an exposed root surface. SDF can be applied to root surfaces, a common area for decay, especially in older adults.

Periodontal Disease: SDF can also be applied to the the margins of crowns, grooved areas of exposed roots from gum recession, and periodontal pockets to aid in managing periodontal disease.

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A well-rounded dental treatment plan is essential for maintaining oral health and preventing future complications. Prioritizing minimally invasive dentistry whenever possible helps preserve natural tooth structure and enhances patient comfort.

When presented with a treatment plan, we hope patients can use this visual to understand where the treatments are being proposed in the mouth and to advocate for maintaining their natural tooth surfaces as a first step.

Always engage in open communication with your dental professional to ensure you understand your oral health status and available treatment options. This informed decision-making process will empower you to choose the best course of action for you and your family, ultimately leading to healthier smiles.

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References

1. Benzian H. Dental public health breakthrough. Br Dent J. 2022 Apr 8;232(7):421–421.
2. Frencken JE, Peters MC, Manton DJ, Leal SC, Gordan VV, Eden E. Minimal intervention dentistry for managing dental caries – a review. Int Dent J. 2020 Nov 6;62(5):223–43.‍
3. Ethics and Dentistry [Internet]. [cited 2024 Feb 20)
4. ‍Minimally Invasive Care [Internet]. CareQuest Institute for Oral Health. [cited 2024 Feb 20].‍
5. Silver Modified Atraumatic Restorative Technique (SMART): An Alternative Caries Prevention Tool | University of the Pacific [Internet]. [cited 2024 Feb 20].‍
6. Marley. World Health Organization (WHO) Recognizes Silver Diamine Fluoride as Dental Essential Medicines [Internet]. Oral Health Group. 2023 [cited 2024 Feb 20].‍
7. World Health Organization. Executive summary: The Selection and Use of Essential Medicines 2021. Report of the 23rd WHO Expert Committee on the Selection and Use of Essential Medicines. Virtual meeting, 21 June-2 July2021 [Internet]. [cited 2024 Feb 20].‍
8. ‍Silver Diamine Fluoride [Internet]. [cited 2024 Feb 20].

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