Dental Health Articles
Minimal Intervention (MI) Dentistry
By Nick K. Nguyen, DDS, APC
You may begin to hear more about the term "Minimal Intervention (MI) Dentistry". MI is a less invasive approach to dentistry, involving use of existing knowledge and available resources to aid dental practitioners in establishing and maintaining good oral health in their patients. The goal is to heal the mouth while reducing the need for removal of tooth structure. This is important because once "holes" are made in a tooth, such as when a cavity is removed, the tooth becomes forever weakened and vulnerable. This could lead to possible major reconstructive dentistry in the future.
MI continues to promote what most people have already heard from their dental offices, which is that cavities (caries) and gum disease can be prevented or minimized through proper brushing, flossing, and having routine professional cleanings. The problem is that dentists now also have available technologies such as digital x-rays and laser cavity detectors (Diagnodent) to help detect caries at early stages. Although detecting caries at earlier stages could prevent further decay, treatment does not always necessitate removal of tooth structure but still depends on the caries location, and the medical condition and habits of the patient.
MI advocates that not all small caries need to be treated by tooth removal. Superficial caries that have not penetrated to the deeper layers can still disappear or remineralize. Brushing and flossing can help delay the progression of the caries. However, this may not be enough. The environment of the mouth is a very important factor in influencing the development of caries and gum disease. This includes pH levels, salivary flow, and mineral levels. Ideal saliva has neutral pH and contains proper amounts of buffers and minerals, including calcium and phosphates. When we eat or drink, the pH level of our saliva drops to acidic levels causing our teeth to "soften", making them susceptible to decalcification. This happens because most foods and drinks are acidic and this acidic environment allows acid loving bacteria to flourish. These bacteria actually secrete more acid as a bi-product, further lowering pH levels. The natural enzymes and buffers in a normal mouth would neutralize saliva pH within 20 minutes. However, people with certain medical conditions, on certain medications or with salivary gland dysfunction may not be able to neutralize their saliva pH within this normal amount of time. Therefore, having a specialized regimen of calcium/phosphate pastes, bicarbonate/fluoride toothpastes, xylitol products, in addition to having a good diet and oral hygiene becomes very important. This regimen can even help people with normal saliva who have begun to develop insipient caries. In other words, we can heal or reverse certain types of caries making it unnecessary to make "holes" in teeth. This should make everyone smile.
Did you know?
- It is more effective to floss before brushing.
- Eating or drinking immediately following tooth polishing softens teeth and increases your chances in developing caries. After a dental cleaning, wait at least 30 minutes before eating or drinking.