Let’s be honest. It’s the dream, it’s the hope, and it’s the goal. No-drill dentistry is the holy grail millions of miserable patients are looking for when seeking out dental care. An endless cycle of drill and fill dentistry is leaving a (forgive the pun) bad taste in our mouths! As patients, we want to have comfortable dental care that preserves the health of our teeth over the course of our entire lifespan. As providers, we want to have great relationships with happy patients who come back regularly for good care and are satisfied with their excellent oral health. But can it happen? Is no drill dentistry a real possibility or just an overblown buzz word?
Breaking the Cycle
There’s a reason drill and fill is thought of as an endless cycle. It is, at best, symptom treatment only. No amount of drilling out decay will cure the underlying infection that causes cavities to develop in the first place. Treating symptoms without doing the work to identify the root (sorry) causes of the problem practically guarantees that the problem will grow unchecked. More rounds of drilling and filling inevitably result. The first step to putting the drill away is to identify and treat the disease, not just the symptoms.
The What in the Why
When what you have is caries disease, the ‘why’ you have it may take some investigating. For many patients, low pH is causing and contributing to the overgrowth of cariogenic bacteria. Those bacteria love acidic conditions and have no regard for the tooth structure that cannot withstand an acid onslaught. Raising the oral pH with an appropriate oral care regimen makes it harder for infectious bacteria to survive and easier for necessary minerals to redeposit into enamel surfaces. Dry mouth might be the biggest threat to tooth health for a patient. Without the protective factors of saliva, teeth quickly suffer. Alleviating dry mouth can relieve stress on the teeth contributing to caries formation.
Know Your Risk
A risk assessment is as valuable a dental tool as a physical probe when employed correctly. Knowing your risk (or your patient’s risk) factors and levels can guide you to the correct treatment options and away from the drill. Fluoride varnish is recommended by the ADA for high-risk patients, recognizing varnish’s superior potential to stave off disease progression. Homecare decisions, such as antimicrobial rinse or no, also need to be guided by the risk assessment to provide the most benefit.
When Risk Wasn’t Reduced in Time
If it seems like the key to no drill dentistry is to prevent cavities from forming, that’s because prevention is the best remedy to dental issues. But, it’s not possible to travel back in time to prevent current problems. So, what options are there for patients who have some lesions? Patients that have large carious lesions may need some restorations, but there are plenty of reasons to wait and try remineralizing treatment and careful monitoring of smaller lesions. Even on spots that need treatment, children who cannot handle a drilling session may find relief with silver diamine fluoride treatment, despite its cosmetic shortcomings.
No Drill? Use the Right Team!
The key to success is to find a professional team that shares a no drill, whole mouth treatment goal. Find a Caries Risk Assessment trained dentist in your area and take a new approach to your oral healthcare.