Tell the truth now: do you avoid the dentist, even just a little, because you shudder at the thought of that whiny drill boring a hole in your teeth?
Well, it’s good news for you because a new study by the University of Sydney has found that tooth decay (dental caries) can be stopped, reversed, and prevented without need for the ‘fill and drill’.
The results of the seven year study found the need for fillings could be reduced by 30 to 50 per cent by preventative oral care.
The study’s lead author, Associate Professor Wendell Evans of the University of Sydney, says in many cases, fillings are simply not necessary.
“This research signals the need for a major shift in the way tooth decay is managed by dentists – dental practice in Australia needs to change. Our study shows that a preventative approach has major benefits compared to current practice.
“For a long time it was believed that tooth decay was a rapidly progressive phenomenon and the best way to manage it was to identify early decay and remove it immediately in order to prevent a tooth surface from breaking up into cavities. After removing the decay, the affected tooth is then restored with a filling material — this process is sometimes referred to as ‘drilling and filling’.
“However, 50 years of research studies have shown that decay is not always progressive and develops more slowly than was previously believed. For example, it takes an average of four to eight years for decay to progress from the tooth’s outer layer (enamel) to the inner layer (dentine).
“That is plenty of time for the decay to be detected and treated before it becomes a cavity and requires a filling.”
Professor Wendell Evans and his team developed the Caries Management System (CMS) as an alternative to reaching for the drill.
When tooth decay is detected, the CMS comprises four parts:
1. Application of high concentration fluoride varnish by dentists to the sites of early decay.
2. Attention to home tooth brushing skills.
3. Restriction of between-meal snacks and beverages containing added sugar.
4. Risk-specific monitoring.
“The CMS was first tested on high risk patients at Westmead Hospital with great success,” said Professor Evans. “It showed that early decay could be stopped and reversed and that the need for drilling and filling was reduced dramatically.
“A tooth should be only be drilled and filled where an actual hole-in-the-tooth (cavity) is already evident,” he said.
Further testing has shown that as many as 30 to 50 per cent of fillings were unnecessary.
“The reduced decay risk and reduced need for fillings was understandably welcomed by patients,” Professor Evans said. “However, patients play an important role in their treatment. This treatment will need a partnership between dentists and patients to be most successful.”
Do you dread the drill? Will you ask your dentist about CMS next time you visit?