No-drill dentistry means fewer fillings



no-drill dentistryA new study from the University of Sydney says tooth decay can be stopped and even reversed with no-drill dentistry, reducing the need for fillings in 80 per cent of cavity-prone patients.

Australian dentists need to move away from the drill-and-fill approach and adopt a preventative toolkit, says associate professor Wendell Evans, lead investigator of the oral health study.

It has long been believed that decay occurs rapidly, and the best way to prevent further deterioration was to drill and fill the cavity—even in the earliest stages.

Professor Evans, citing the results of his seven-year study into ‘no-drill dentistry,’ says: “It’s unnecessary for patients to have fillings, because they’re not required in many cases of dental decay. 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.

“A tooth should only be drilled and filled where an actual hole in the tooth [cavity] is already evident,” he concluded.

The ‘no-drill dentistry’ study compared more than 1000 patients at 22 dental practices across NSW and the ACT, with only some locations having fluoridated water.

Half the patients were treated according to conventional methods, while the other was treated using the Caries Management System—a preventative regime used on teeth, where decay is present but has yet to progress to a cavity.

The new approach includes:

  • Application by dentists of high-concentration fluoride varnish on teeth showing signs of early decay
  • Advice on how to brush teeth better
  • Restriction of between-meal snacks and drinks containing added sugar
  • Monitoring according to level of decay.

Those patients that fell into the “high risk” category, requiring two or more fillings a year, saw an 80 per cent reduction, says Professor Evans.

The impact no-drill dentistry could have on the percentage of the population reported to have a dental phobia may well be striking. The figure is reported to be as high as 15 per cent of Australians—and is often related to a fear of drills, according to a recent study by King’s College, London.


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