Minimum Intervention in Dentistry
UK, September 2, 2024 - The concept of minimum intervention in dentistry (MID) ranges from early diagnosis of oral disease to appropriate intervention, which includes prevention, control and treatment for the purpose of conserving natural tooth and periodontal structure.
A number of MID measures have recently become available, including the very early detection of dental caries using QLF (Quantitative Light-induced Fluorescence) in order to detect mineral loss in enamel, as well as follow-up strategies, such as remineralisation and the use of sealant.
Moreover, the visual FDI Caries Matrix, in terms of non-cavitated and cavitated lesions in enamel and dentine, has been proposed as a caries index for timely prevention and treatment.
This early detection and diagnosis of dental caries will lead to proper prevention and control of caries before the development of a cavity, which can then only be treated.
For caries restoration, partial caries removal during cavity preparation has been suggested, which, according to research, appears to reduce the incidence of iatrogenic pulp exposure and therefore the risk of pain and infection.
Simplified and modified atraumatic restorative treatment, a further development of atraumatic restorative treatment (one of the original MID methods of restoration) and a preventive method of restoration for primary teeth that entails partial caries removal and filling with encapsulated self-curing glass ionomer cement, has been proposed.
This concept makes preventive restoration in preschool children, even by trained dental auxiliaries, possible.
Moreover, effective use of self-care fluoride toothpaste during tooth-brushing has been suggested for every age group, especially the correct minimal amount of toothpaste used in children to prevent both caries and fluorosis.
There are several interesting MID measures in terms of periodontal disease, such as non-surgical or minimally invasive surgery in periodontal therapy, and single-flap or flapless implant surgery.
The single-flap approach is a minimally invasive surgical procedure for the reconstruction of intraosseous periodontal defects with early wound healing and highly predictable complete flap closure.
The effectiveness of the buccal single-flap approach for surgical debridement of deep intraosseous defects has been shown to be comparable to the double-flap approach in terms of clinical attachment level gain, probing pocket depth reduction and minimal gingival recession, six months post-surgery.
Another minimally invasive surgery method is flapless implant surgery conducted with help of the tissue punch technique instead of having to raise a mucoperiosteal flap.
Reports show that this reduced operational time, accelerated post-surgical healing and even increased patient comfort in some cases.
MID can be applied in many areas of clinical dentistry.
Importantly, it should be part of a science- and evidence-based practice that is able to provide dental services that are accessible to, acceptable to and affordable for an increasing number of people.
Prof. Prathip Phantumvanit is currently Vice-Chairman of the Public Health Committee of the FDI World Dental Federation.
Today, he will be presenting a paper titled “Minimum intervention dentistry” during one of the early morning sessions as part of the 2013 FDI AWDC scientific program.
