Research published in Community Dentistry and Oral Epidemiology has shown that the need for fillings can be reduced by 30 to 50% through preventative oral care. This means that many previous fillings are not needed when dental decay occurs. As such a preventative approach can be beneficial when compared to current dental practices.
Dentistry has been traditionally practiced with the believe that tooth decay rapidly progressed and the best way to manage it was to identify early decay and remove it quickly to prevent the tooth surface form developing cavities. After the decay is removed the tooth is restored with a filling material.
Fifty years of research studies have shown that decay is not always progressive and develops more slowly than previously thought. It can take an average of four to eight years for decay to progress from the tooth’s outer layer to the tooth’s inner layer. As such quickly moving in to make a filling may not be the best approach.
The study’s author Wendell Evans and his team developed the Caries Management System which is a set of protocols which cover the specific treatment of early decay, the assessment of decay risk, and the interpretation of dental X-rays.
The ‘no-drill’ treatment involves four aspects:
1. Applying fluoride varnish by dentists to any sites of early decay
2. Paying attention to home tooth brushing skills
3. Restricting snacks and beverages containing added sugar
4. Monitoring any specific risks.
The authors have tested their approach on a few patients and the early results have showed early decay could be stopped and reversed and performing drilling and filling can be reduced. The treatment was performed at general dental practices in New South Wales and Australian Capital Territory.
Source: R. Wendell Evans, Paula Clark, and Nan Jia. The Caries Management System: are preventive effects sustained postclinical trial? Dec. 7, 2015.