|
|
|
|
MICRO DENTISTRY
|
|
|
|
|
What is Air
Abrasion?
Air Abrasion is a gentle spray of an air and powder mix that
removes tooth decay. By controlling the speed and the intensity
of both the powder and the air,we can make the procedure
virtually painless. Since a shot is not necessary in most cases,
you will not have numb or drooping lips after your dental
procedure.
Air Abrasion almost never hurts - making it great for kids as
well as adults.
Tell me a little
more about air abrasion.
Since Air Abrasion
is achieved by directing a thin stream of abrasive powder at the
area of tooth decay, we remove only minimal sections of tooth -
just the decayed area. Until now, all the dentist had available
was that noisy drill. But it was so big in comparison to our
beam of powder that it removed a lot of healthy tooth structure.
Air Abrasion allows for very small cavity preparations and is
part of what is called MicroDentistry.
Why is Air
Abrasion better than the old drill?
The Air Abrasion
device that we use is state-of-the-art. Its technology
eliminates the odors, noise, vibration, micro-cracks and, in
most cases, no shot associated with the drill.
Once Air
Abrasion removes the decay, how is the cavity filled?
This is the
beautiful part - literally! we will fill that cavity with a
nearly invisible, non-mercury filling, making the entire tooth
strong, long-lasting and resistant to decay.
Can children as
well as adults benefit from Air Abrasion?
Absolutely! Air
Abrasion is perfect for children. Most cavities that are
detected early can be treated immediately without a drill and
without a needle. The tooth is then restored with natural
looking materials to strengthen and protect the remaining tooth
structure. Most children are not even aware of what the dentist
is doing. Fewer dental appointments for the young patient are
usually required because with Air Abrasion many more procedures
can be completed in a single appointment!
|
|
|
The
History of Air Abrasion
Air
abrasion was first introduced to dentistry in the early
1950’s. It did not gain recognition or acceptance at
that time for two reasons:
1. The
equipment was rather bulky and the delivery system was not
refined.
2. The high
speed turbine was coming into prominence at the same time
and was a more familiar treatment method to the dentist.
Factors
That Re-established Air Abrasion
as
a Method of Treatment
1.
The Introduction of Fluoride.
Fluoride
appeared in the mid-1950’s as an anti-carious additive.
It was introduced to the public in two ways, by being
added to the public drinking water affecting the
developing tooth, and by being added to tooth paste to
provide a topical application. The effect of fluoride is
most evident on the smooth surfaces of the teeth where
interproximal decay has been greatly reduced. However, on
the occlusal of the posterior teeth where the pits and
fissures are located, the decay process occurs differently
than it did prior to the introduction of fluoride.
Prior
to fluoride, as the decay progressed down the grooves, it
destroyed the surrounding tooth structure, forming a
funnel shaped lesion. This enabled the dentist to visually
see the decay process soon after it began. If the explorer
would "stick" or if the decay was evident on a
radiograph, the dentist would treat it. Until the time of
treatment, the lesion was monitored. This is how and why
"watch" areas became part of the standard
treatment regimen. However, with fluoride, the decay
process does not break down the surrounding enamel as it
progresses down the grooves because the enamel is so hard.
Instead the decay moves down the grooves, penetrates the
enamel and undermines it. There is little or no visual
changes on the surface of the tooth and the explorer does
not "stick".
2.
The Change in Radiographic Film
X-ray
units sold previous to the early 1960’s were 65KV
machines. The film speed used was slow and as a result the
radiation necessary to expose this slow film required the
patient to be radiated for a period of two to three
seconds for the typical periapical or bite-wing. In the
1960’s and 1970’s, radiation exposure became an
important issue to the general public. Dentists and other
health care practitioners were instructed to reduce their
diagnostic radiation. As a result, faster film was
developed that required less time for the patient to be
exposed to the X-rays. The use of faster film also reduced
the clarity or definition of the radiographs. This results
in occlusal decay not being seen until the areas are very
large.
The
Results of the Combination of Fluoride and Faster Film
The
introduction of fluoride has produced an entire generation
who, for the most part, only have restorations on the
occlusal of posterior teeth. This is an advancement over
the previous generations’ dental condition. However,
most of these occlusal restorations are the typical G.V.
Black "extension for prevention" amalgams. This
means waiting until areas of decay are evident on a
radiograph or until an explorer "sticks",
results in a much larger restoration than is necessary in
the light of today’s expertise.
Haven’t
we all decided to treat an occlusal pit or fissure of a
molar we first saw as a "watch" area one, two,
perhaps three years earlier, only to now discover a large
area of decay not visible on the bite-wing radiograph?
Sound
familiar?
CONCLUSION:
Using only radiographs and the explorer to diagnose
occlusal decay will result in unwarranted removal of good
tooth structure because caries detection is delayed!
How
Occlusal Decay Should be Diagnosed and Treated Today
1. Caries
Detecting Solution
Other
methods of detecting occlusal decay have to be performed.
The caries detection solutions that have recently been
developed will now show the pits and fissures that need
treatment long before they can be detected with the older
method of radiographs and an explorer. The diagnostic
procedures adequate in the 1950’s through the 1980’s
are no longer proper treatment. Caries detecting solutions
must be applied to help dentists diagnose
decay before it progresses too far.
2.
Micro Air Abrasion
The
technique of Micro Air Abrasion allows a dentist to remove
areas of a tooth as narrow as 1/50th of an inch. Once the
air abrasion technique is mastered, these pits and
fissures can be treated much earlier than before,
resulting in a minimal amount of tooth structure being
removed. This can be accomplished about 90% of the time
without the use of a local anesthetic, without the sound
so many patients object to, and without the vibration of a
rotary instrument. When minimal tooth structure is
removed, bonded composite resins can be placed which
restore the tooth to 90-95% of its original strength and
100% of its original appearance. Patients are enthusiastic
when they realize decay removal can be accomplished as a
pleasant experience long before complications occur.
A
Simple Test To Perform
Collect
a number of extracted teeth. Determine which teeth appear
to have "watch areas" and which have no visible
decay on the occlusal surface. Separate them into two
groups and take radiographs of each tooth. Discard any
teeth on which you are able to see occlusal decay. Mark
the remaining teeth so as to be able to identify the
corresponding radiographs. Next, apply caries detecting
solution to the occlusal surfaces of all the teeth. After
10 to 15 seconds wash off the excess solution. (I suggest
using a green color solution rather than red because of
its higher visibility.) The teeth you determined had
"watch" areas will retain the stain. You will
also discover that 75-85% of the teeth you determined had
no decay, will show pits and fissures that are stained by
the caries detecting solution. Remove the teeth that did
not retain any stain from the test. Now you will have a
collection of teeth that will exhibit stain in occlusal
pits and fissures which can be checked with the
radiographs, and prove that the radiographs show no enamel
penetration of decay into the dentin.
Using
your high-speed hand-piece, remove the stain from these
grooves. When all the stain is gone, re-stain the teeth.
(The solution does not fully penetrate the whole of the
decayed area at one time.) Keep removing the stained tooth
structure and re-stain until the tooth no longer retains
the stain. It will help to use some form of magnification
because the tortuous path carious lesions can take can be
difficult to follow.
You
will find virtually 100% of your "watch" areas
and 85% of those in the group you felt had no decay (but
retained stain in the pits and fissures) will have caries
that extend into the dentin. Serially section the teeth to
exactly check the dentinal penetration. Now check the
radiographs. WOW! Was the width of the preparation
you made in these teeth wider than 1mm? If the tooth had
been diagnosed earlier with caries detection solution and
treated with air abrasion, the preparations would have
been only 1mm wide. If these were your teeth, or those of
your family, how would you want them treated?
THE
EARLY DETECTION AND TREATMENT OF OCCLUSAL DECAY IS
ESSENTIAL. HOWEVER, YOU MUST USE CARIES DETECTION SOLUTION
AND MICRO AIR ABRASION TO ACCOMPLISH THIS!
|
|
|
|
Home