A No-Cringe Fix? Filling Cavities Without The Drill A widespread aversion to drills is inspiring some dentists to look for new ways to treat cavities without them.  But some question whether a new treatment using a mild acid and resin will hold up over time.
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A No-Cringe Fix? Filling Cavities Without The Drill

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A No-Cringe Fix? Filling Cavities Without The Drill

A No-Cringe Fix? Filling Cavities Without The Drill

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If hearing a dental drill sets your teeth on edge, here's something you'll enjoy hearing. Gretchen Cuda of member station WCPN in Cleveland reports on a new procedure that treats cavities without drills and Novocain.

GRETCHEN CUDA: It's just past eight o'clock in the morning, and Kimberly Baker is reclining in the dental chair at Case Western Reserve School of Dental Medicine.

Unidentified Man: Is this OK, Kim?


Unidentified Man: OK.

CUDA: Baker has three cavities. This morning, she'll be getting two large cavities drilled the old-fashioned way, but the third is a decay that's not so advanced. And her dentist, Dr. Jin-Ho Phark, is going to use a treatment he's testing that involves no drilling.

Dr. JIN-HO PHARK (Dentist): Which is nice, 'cause many patients don't like the sound of the drill.

CUDA: The treatment is named Icon, and it's one of a several new cavity treatments that avoid drilling. Icon was developed in Germany, and it's been available in the U.S. for just over a year. Icon's intended for patients whose decay has not gone beyond the tooth enamel.

Jin-Ho Phark says that when decay is caught very early or very late, dentists have a clear course of action: Early problems can often be reversed with better brushing, fluoride or calcium-containing toothpastes, and late-stage cavities need to be filled. But at the intermediate stages, dentists don't have many options.

Dr. PHARK: In many of those cases, we decide, okay, this lesion is too small to be treated with a filling. So we are actually waiting until the lesion grows bigger and bigger and is then deep enough and worthy to be drilled out and then to be filled.

CUDA: German researcher Sebastian Paris is a dentist and one of the treatment's developers.

Dr. SEBASTIAN PARIS (Dentist): We aim to treat these intermediate lesions, where usually, as a dentist, you are not sure whether you should make a filling or not.

CUDA: When tooth decay begins, minerals like calcium are leeched out of the tooth, leaving behind sponge-like pores in the enamel. If the decay process is allowed to continue, the pores grow and form a hole, known as a cavity.

The new treatment uses a coating of mild acid that's applied to the decay to open up a route to the pores and clear out decayed enamel. Then the open pores are filled with a clear material called a resin.

Paris says the key to getting the treatment to work was finding a filling material that wasn't thick and goopy so the porous enamel would immediately suck it up like a sponge.

Dr. PARIS: When you take a sugar cube and you put this into your coffee, you will see that the sugar cube is soaked up with the coffee. But you can imagine that when you put your sugar cube into honey, for example, you can imagine that it will take ages to soak up the honey into the sugar cube.

CUDA: Avoiding the drill has the advantage of preserving and extending the life of the natural tooth. However, some dentists argue that any time before a cavity actually forms, tooth decay can be stopped and even reversed by the patients themselves.

Professor MARK WOLFF (Dentistry, New York University): An alternative could very simply be brushing better in a location and not drinking Coca-Cola all day long or a product that contains lots of sugars in it.

CUDA: Mark Wolff is a professor of dentistry at New York University who specializes in cariology, the study of tooth decay. He says that while the no-drill approach to treating this type of tooth decay has promise, fluoride treatments and other patient-applied methods are still more inexpensive, less invasive, and have a much longer track record of success.

Prof. WOLFF: Might this be a good aid to help that person prevent these cavities from advancing? Absolutely. I think the jury is still out on the product a little bit. Hopefully, it works. I think that it's just in its earliest stages.

CUDA: Since it's so new, it's still unclear how the Icon resin filling holds up over time. And clinical studies have shown that the treatment fails to stop decay from advancing in up to 15 percent of patients.

But Wolff also admits that if a patient isn't able or willing to change their dental hygiene habits, or they have conditions that predispose them to tooth decay, this may be a good solution for keeping the dentist's drill...

(Soundbite of dentist drill)

CUDA: ...at bay.

For NPR News, I'm Gretchen Cuda.

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