A Better Way to Treat Dental Decay?

Your dentist may be ready to get less aggressive about managing tooth decay. In fact, you may be able to avoid an encounter the dreaded drill altogether.

Rather than drilling and filling as soon as they spot a bit of decay, dentists may opt to use the new “Caries Management System” (CMS) to keep your teeth healthy.

In a seven-year study, researchers in Australia found that not all tooth decay is created equal. Rather than automatically drilling out decay to stop its progress, the study indicated that some decay can be treated, stopped and even reversed utilizing CMS processes.

CMS involves the application of high concentration fluoride varnish by dentists on early decay, paying attention to the patient’s tooth-brushing skills, a healthier diet that includes very limited intake of sugary snacks and beverages, and regular checkups at the dentist.

Over the course of the study, researchers reported that decay was reduced in CMS participants by 30 to 50 percent on average. For those patients who were getting as many as two fillings per year, the reduction was even more significant – they saw am 80 percent reduction in the progression of dental decay.

Current dental best practices are based on the theory that tooth decay will quickly, inevitably progress to a huge cavity. Based on this, dentists typically try to identify decay as early as possible and purge it from a tooth by drilling it out and then filling it. But newer research, including the Australian study, has shown that decay tends to take an average of four to eight years to move from the outer layer of tooth enamel to the inner layer. Once decay moves inside enamel, a root canal may be required to clear the decay and save the tooth.

“For a long time it was believed that tooth decay was a rapidly progressive phenomenon and the best way to manage it was to identify early decay and remove it immediately in order to prevent a tooth surface from breaking up into cavities,” Dr. Wendell Evans, an associate professor at the University of Sydney, said in a press release.

“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.”

The researchers worked with 1,000 patients at 22 dental practices, researchers at the University of Sydney compared people who 19 dental practices, with some using the CMS method and others the traditional drill-and-fill method. Patients outcomes were studied over a three-year randomized clinical trial, researchers then followed up with them two and four years after the end of the trial.

“It showed that early decay could be stopped and reversed and that the need for drilling and filling was reduced dramatically,” Evans said. “A tooth should be only be drilled and filled where an actual hole-in-the-tooth [cavity] is already evident.”

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