Minimal Intervention Dentistry
Minimal intervention dentistry aims to preserve and retain as much natural tooth as possible while treating the disease that causes tooth decay. Minimal intervention (MI) dentistry addresses dental caries, the pathology underlying tooth decay, focusing treatment guidelines on managing the disease before restoring the decayed tooth, using dental fillings only when necessary, and preventing future decay. MI dentistry is a recent innovation in dentistry, first classified in 1997, and was first introduced with the goal of remineralizing dental lesions early on, before they develop into full-blown cavities. Since its introduction, it has gained respect as a valid and often successful approach to dental treatment.
Traditional recommendations for reducing tooth decay and cavities, including dietary modification and an effective oral hygiene regimen, remain integral parts of the prevention and treatment of cavities. As research in the fields of dentistry progresses, dentists have also been using certain biochemical treatments, such as chlorhexidine and Xylitol, to address bacterial infection and other risk factors for cavities. MI dentistry also includes the use of technological treatments, like photo-activated disinfection, and suggests that minimizing the effect of dental caries will lead to controlling the symptoms of decay. Consistent application of fluoride to the teeth, either through regular use of fluoride toothpaste or through fluoride treatments applied in a dentist’s office, can lead to the remineralization of the teeth, reducing the effects of dental caries on eventual decay. The introduction of certain drugs into the system can affect the saliva and help it to build resistance to acidity, also helping reduce the deleterious effects of dental caries on the teeth by reducing the acid bath that they may cause.
Tooth decay occurs when an area of the tooth becomes demineralized, which creates a lesion of decay on the tooth. When tooth decay can be reversed, it has not yet developed into a cavity and may be healed through remineralization. If a cavity has formed, the decay can no longer be reversed, and a filling must be placed in order to save the tooth. MI dentistry aims to remineralize any areas of decay that have not yet developed into fully formed cavities, allowing as much of the natural tooth as possible to remain intact and in use. Because it is necessary to remove portions of a tooth to place a filling, remineralizing decay allows dentists to retain as much of the healthy tooth as possible, placing fillings only when and where a cavity has developed. This is beneficial for both aesthetic and functional reasons.
MI dentistry includes a classification system that allows dentists to determine the possibility of remineralizing teeth and to diagnose irreversible cavities. Upon assessing the extent of decay, dentists who adopt the MI paradigm will then determine the restoration techniques necessary for any fully cavitated sites while also addressing remineralization treatment for areas that are not yet cavitated. Some remineralization techniques employ filling materials that aid in remineralization from inside the tooth, while other techniques, like the application of fluoride, are less invasive. While addressing existing lesions and employing remineralization treatments, dentists using an MI approach will also treat the teeth to prevent future decay, allowing the treatments for the disease to also be used to prevent the disease itself.