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All the below content has been written by Dr. Sandip Sachar.
Dentist NYC: Minimally Invasive Dentistry
What is minimally invasive dentistry?
Minimally invasive dentistry is a philosophy that is adhered to at Sachar Dental NYC. In general terms, minimally invasive dentistry is the belief and application that we always perform the least invasive, and the most conservative treatment options available. It is a philosophy that we have adhered to at all times for the past two decades.
Going into more detail, there are many ways that we apply this philosophy. We believe in having “respect for the original tissue”. We use this philosophy with all of the invasive procedures that we perform. We always try to reduce the amount of drilling of the natural tooth structures as much as possible. At the same time, we are able to solve virtually all problems presented to us, while remaining conservative.
This also applies to a strong emphasis on prevention rather than cure. We always try to identify and manage disease processes in their early stages, before more invasive procedures become necessary. For example, we encourage our patients to adhere to a strict schedule of coming in for their dental cleanings and dental checkups in order to catch problems early before we need to perform invasive procedures. Another good example of the application of this philosophy, is “re-mineralization”, rather than drilling for a cavity. See “re-mineralization“ below for more details.
Minimally invasive dentistry techniques include:
Tooth colored resin fillings
Minimally invasive dentistry was not always an option. The invention of tooth-colored, resin-type fillings, that replaced silver, amalgam fillings played a big part in the origin and philosophy of minimally invasive dentistry. In the past, in order to fill a cavity with amalgam fillings, we had to rely on “mechanical retention “. This simply means that the shape of the area of the tooth that we drilled had to be wider at the deeper aspect, than at the superficial aspect. The amalgam filling would then not be able to come out of its cavity due to its shape. Newer, tooth-colored, resin fillings rely on a chemical bond between the filling material and the tooth. This produced a huge advantage in dental fillings. It allows us to remove much less of the natural tooth because we do not need to have that wider part drilled in order to retain the filling. We are able to remove only the decayed parts of the tooth, and a resin filling bonds to the tooth, and does not fall out.
These technological advances in dentistry allow us to remove as little of the natural tooth as possible, and also allow for much longer lasting dental materials that do not need be to be replaced or redone.
The disease process of cavities forming in our teeth starts with the de-mineralization of the tooth enamel causing the surface of the tooth to become softer. In the very early stages of cavities forming, this process can be arrested through re-mineralization. In these early stages, the cavity is only present superficially in the tooth enamel.
Re-mineralization is done by the topical application of fluoride. By restoring minerals in the tooth, this can help to restore the strength and hardness of the tooth enamel, and also stop the cavity from getting larger. Re-mineralization can repair the damage created by the de-mineralization process.
For example, when patients come in with small cavities that are only in the outer surface of the tooth enamel, it is our philosophy to first treat these patients with a fluoride treatment, rather than to drill the tooth and place a filling. In our experience, many patients respond to this treatment and never need to have the cavity filled. We then check every 3-6 months at your normal routine checkup and monitor the area.
Sealants are made out of a resin that is similar to tooth colored filling materials. When we identify deep grooves or depressions in the teeth that may harbor bacteria and lead to tooth decay in the future, we will often recommend a sealant procedure. Sealants fit into these grooves and depressions and protect the tooth by acting as a barrier the build-up of plaque, bacteria and tartar. Sealants are usually used on children, but can be used on adults as well. The application of sealants does not require any drilling of the teeth.
Porcelain dental inlays and onlays
Tooth decay and cavities are often identified when they are very large, and are sometimes too large to be filled with traditional cavity filling materials. At this stage, we will make the decision whether to perform an inlay or onlay porcelain filling, or to use a crown. The application of a crown requires removal of much more of the natural tooth than the inlay or onlay porcelain filling do. By using an inlay or onlay porcelain filling, we are able to save more of the natural tooth. The inlay porcelain fillings consist of a custom fabricated piece of porcelain that is made in our dental laboratory. It is permanently bonded to the tooth in order to fill a large cavity. An inlay porcelain filling is utilized when the cavity lies within a tooth, and it is surrounded by healthy tooth structures on all sides. An onlay porcelain filling is similar to an inlay porcelain filling, however, it is used when one or more of the outer parts of the tooth are affected by decay or trauma. Both inlay and onlay porcelain fillings are more conservative and require removal of less of the natural tooth structure than applying a crown to the tooth.
Mouth guards are an excellent example of using preventative measures before damage to a tooth occurs. Many dental problems can be attributed to clenching and grinding of the teeth. There are many reasons why patients may clench or grind their teeth. Patients that clench or grind their teeth usually do this at night while there are sleeping, and unaware. Clenching and grinding can cause wearing away of the tooth enamel. In later stages, this can result in chips, fractures and cracks in the teeth. It can also result in temporomandibular joint (TMJ) pain.
The use of a night guard protects the teeth before damage can occur, to the teeth or the TMJ joint. Mouth guards are custom made by taking a mold of your teeth. They are made of durable materials that last for a long time. At Sachar Dental NYC, we only use BPA-free materials when fabricating our mouth guards.
Sachar Dental NYC
At Sachar Dental NYC, our philosophy is always to use the least invasive procedures and most conservative options available. As you can see from the above narrative, this applies to many aspects of how we perform dentistry. Additionally, we perform green dentistry. We invite you to come see for yourself how we practice differently and superior to other dental offices.
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