Minimally Invasive Dental Treatments
Minimally invasive dentistry provides conservation of healthy tooth structure. It starts with prevention (hygiene, check-up, diet, smoking, systemic problems, fluoride, sealant) and if something goes wrong, continues with remineralisation and minimal interventions. The aim is never to remove more tooth structure than it is needed, then to restore teeth with the appropriate method.
If caries is detected before there is a “hole” on the tooth, it may be remineralised, usually by means of local fluoride application and saved without any additional intervention. Follow-up is of utmost importance as the area is already delicate. If there is already a cavity formed, then the decayed tissue needs to be removed and the space needs to be restored. Only the minimum removal of tooth structure that is needed is carried out by a dental hard tissue laser. With the laser only caries is removed on the borders of the decay when the correct parameters (need for laser education) are used.
Minimally invasive dentistry is also relevant to the type of restoration that is used. For a caries restoration there are two ways to prepare the cavity; for tooth coloured composite fillings there is no need for the cavity to have a specific shape, only caries is removed. For amalgam to be used, the cavity needs to be shaped specially for retention of the material. The amalgam fillings are known to be long lasting; however the initial preparation of the tooth causes a considerate amount of healthy tissue loss. While the cavity preparation for composite fillings is minimal, composites are thought to be less long lasting. However the new technologies in the production of polymers improve the properties of dental composites.
If a larger or deeper restoration than a filling is required, the minimally invasive treatments to be considered are inlays or onlays. They preserve the tooth structure compared to full crowns because they are places in or on teeth instead of around. They can either be made of composite or porcelain, the latter being more long lasting.
Misaligned teeth are best to be treated with orthodontic treatment. That is “the” minimally invasive intervention for misaligned teeth in means of removing substance. If there is a great concern about social impact of wearing braces for a temporary time or the time orthodontic treatment will need, second minimally invasive treatment is laminate veneers as they require either no removal of tooth tissue or generally less than a millimetre of preparation in thickness.