What is Minimally Invasive Dentistry?
Minimally Invasive Dentistry (MID) is the fastest growing movement within modern dentistry. MID is based on a medical model that controls the disease of dental caries first and then uses minimally invasive techniques to restore the mouth to proper form, function and esthetics.
MID dentists, using magnification and advanced technologies, remove the least amount of tooth structure, bone or soft tissue necessary to eliminate what is unhealthy or diseased. When tooth replacement is necessary, it is performed as conservatively, comfortably, and as beautifully as possible.
What’s Involved with Minimally Invasive Dentistry?
Focusing on prevention, remineralization, and the conservation of healthy tooth structure, minimally invasive dentistry is a highly technical and scientific course of treatment that allows the dentist to perform the least amount of dentistry needed while never removing more of the tooth structure than is required to restore the teeth to their normal condition. Additionally, Dr. Alan Gutierrez uses long-lasting and safe dental materials to reduce the need for future maintenance, maintain an attractive all-white appearance in your mouth, and promote total-body health.
Minimally invasive dentistry techniques include:
- Remineralization: As the process of restoring minerals to the teeth, remineralization can help to repair tooth enamel. In most cases, fluoride treatment plays a large role in the remineralization process.
- Air abrasion: When a tooth is past the point of remineralization and decay is present, Dr. Alan Gutierrez can use air abrasion to remove the decay. Air abrasion replaces the need for the traditional dental drill and often eliminates the need for anesthesia.
- Sealants: Usually made of clear plastic resin, dental sealants form a barrier between hard-to-clean teeth (molars, wisdom teeth, etc.) and decay-causing bacteria. Sealants do not require any alteration to the natural tooth structure, so Dr. Alan Gutierrez can place them on teeth that might be susceptible to decay at any time. But always with the help of the air abrasion.
- Inlays and Onlays: Dental crowns are traditionally used to restore strength, durability, and appearance to a tooth that has been damaged, but crowns tend to require a good portion of the natural tooth be altered or removed. To avoid this, Dr. Alan Gutierrez places inlays and onlays to provide substantial reconstruction conservatively.
- Bite splints: Bruxism, more commonly known as teeth grinding, can cause serious damage to your teeth and contribute to TMJ (temporomandibular) dysfunction. Dr. Alan Gutierrez can provide you with a bite splint to wear at night or during times of high stress to limit your teeth grinding.
What are the Benefits of Minimally Invasive Dentistry?
In addition to keeping the maximum amount of your natural tooth structure intact, minimally invasive dentistry by Dr. Alan Gutierrez can allow for the following:
- More dental work completed in a single dental appointment, limiting the amount of time you take off from work and spend in the dental chair
- Less healing time post-procedure
- Less future dental work to maintain restorative dental measures
- More attention paid to total-body health and a working relationship between your dentist and other healthcare providers
- A new level of comfort during your procedure, decreasing the need for sedation and local anesthesia
This case features a sealant that looks clinically acceptable at low magnification (Figure 1). At high magnification, the sealant continues to exhibit acceptable margins (Figure 2). However, upon removal of said sealant, gross caries were present (Figure 3). This 22-year-old female patient reported sensitivity to sweets in the maxillary left quadrant. She is the daughter of a local endodontist.
This endodontist expressed disappointment with the catastrophic failures found associated with this and other sealants placed on his daughter’s teeth by one of his referring general dentists. Unfortunately, his daughter may eventually need several root canal treatments as a result of the treatment. Yet another endodontist who performed endodontic therapy on his daughter after a failed sealant exclaimed, “Sealants are a sham, I am embarrassed for our profession. David, please send me some fissurotomy burs, some flowable and paste composite, and I will redo these things myself!”
Where does the ADA stand on this issue? Divided! In March of 2008, the Journal of the American Dental Association published the recommendations and findings of the ADA Council on Scientific Affairs in an article promoting the value of traditional “painted on” sealants.
In the article, it states “No mechanical preparation of the pits and fissures is recommended for noncavitated pits and fissures.” Only a few months later, the ADA Professional Product review2 completely contradicted that statement saying “The grooves and pits cannot be cleaned without mechanical devices. One needs something like a fissurotomy bur (Figures 4a to 4d) or AIR ABRASION to do the job properly. Without mechanical preparation, the average penetration of a sealant is, perhaps, only 17% the depth of the groove on average.”
To reserve an appointment with Dr. Alan Gutierrez, call Whittier Dental Arts at (562) 907-6000.