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Intervening as soon as possible
The new approach to dentistry is called micro-dentistry. Simply put, micro-dentistry involves intervening in the decay process as early as possible. Besides largely doing away with the dreaded drill and reducing pain and cost, other benefits of this approach are significantly better preservation of teeth, a huge reduction in the rampant tooth failure and loss resulting from the traditional drill-and-fill approach, and results that are altogether more cosmetically pleasing.
Clearly a key part of micro-dentistry is the early and accurate diagnosis of carious lesions, those sites that flag the initial onset of tooth decay. One way of identifying these is by magnification, so don't be surprised the next time your dentist appraises your pearly whites using something akin to a jeweller's loupe or miner's headlamp.
Other ways of finding decay
Computer imaging and digital x-rays are other ways dentists are now finding small amounts of decay, tiny cracks and other flaws, which are then eliminated. Digital x-rays, which employ up to 90% less radiation than conventional dental x-ray film, also provide much better images.
But the light sabre of modern dental diagnosis is a laser device called Diagnodent. According to Dr Hartshorne, research indicates that this device is capable of detecting tooth decay missed in traditional examinations up to 76% of the time. Its major advantage is that it is able to reveal cavities hidden in tooth crevices.
Air-abrasion: a treatment revolution
If lasers and digital x-rays are re-defining detection, then a technique called air-abrasion is revolutionising treatment - doing away with the need for drilling or injections when preparing caries lesions.
By directing a thin stream of small particles in compressed air through a small nozzle, the dentist is able to safely and painlessly remove decay. Besides the obvious advantages in terms of patient comfort, another major benefit of this 'sand blasting' technique is that the particle stream is extremely fine, so the dentist can treat very small cavities without having to unnecessarily remove healthy tooth structure. It is also much more efficient, so more can be done during a single appointment.
Air abrasion is particularly suited for children under 10, both because it is comparatively painless and because early tooth decay starts in primary and first molars, which have deep cavities that are difficult to clean. These are much easier to reach using air abrasion, so there is no need for parents or dentists to delay treatment.
Unfortunately, air abrasion is not suitable for preparing large cavities or removing old, large amalgams and cannot be used to prepare teeth for crowns, veneers or inlays. Hopefully, through early detection and treatment the need for these procedures will start to diminish.
Prevention in the form of ozone
And something that could play a huge role in this happening is ozone therapy, a preventative treatment that Dr Hartshorne believes could have as much impact on the world of dentistry as the advent of anaesthesia.
It uses ozone gas to blitz the infectious bacteria, Streptococcus mutans and Lactobacillus, in the affected tooth in just ten seconds. This destroys the bacteria and stops the decay process. An added advantage is that the bacterial colonies that can cause tooth decay are totally eliminated for up to 16 weeks.
More good news is that ozone kills the bacteria that cause gum disease. It can also break down the gasses that cause bad breath and the treatment is quick, simple and totally painless.
If after all this you still need a filling, modern, tooth-coloured glass-ionomer 'smart' fillings release fluoride to ensure that your newly repaired tooth keeps healing even after you've left the dentist.
