Filling Free Decay Management

Yes, tooth decay can be treated without fillings! Early decay is a reversible process. The key is to detect it in the early stages when this is still possible. It is helpful to think of this strategy as "medical vs surgical" treatment.

The traditional method of finding a cavity was to stick a sharp metal explorer in the tooth and see if it stuck. Unfortunately, this type of cavity is quite progressed and is needs surgical intervention..a filling. Modern dentistry now gives the dentist many tools to identify and manage decay when it can be healed without a filling. Decay occurs when a tooth loses too much calcium from attack by acid producing bacteria. Fortunately, with proper intervention decay can be halted and teeth can recalcify.

We utilize the following tools to identify this reversible decay:

ClinPro Toothpaste
  • Magnification- Strong dental loupes allow the dentist to visually identify early cavities using a scoring system known as ICDAS (International Caries Detection and Assessment System).
  • Digital X Rays- These help identify early areas of decay between the teeth. Even these cavities are reversible if caught at the right time. Newer digital technology is superior to traditional film for finding early decay. 
  • Logicon Decay Detector - This special software analyzes x-rays to help find decay at its earliest stages. It also ised to monitor changes in areas being treated over time.
  • Laser Detection- The Diagnodent decay detection laser has helped revolutionize the identification and management of decay. Dentist can now detect decay activity long before the old "explorer sticks in the tooth technique" when it is potentially reversible.
  • Risk Assessment- CAMBRA stands for Caries Management by Risk Assesment. This protocol uses a questionnaire to gauge each individual patient's risk profile for future decay. It helps identify which strategies will work best for each patient.

No-Filling treatments are geared to each patient's individual needs identiified with the above techniques. These appraoches include:

  • Silver Diamine Fluoride - We are very excited to introduce a new treatment for tooth decay called Advantage Arrest™. 
    This procedure was recently highlighted on WBAL TV and here is a link to the story.... 
    Imagine treating decay effectively without needing a filling at all.
    This treatment has been available in Europe for many years and just recently got FDA approval for use in the United States. This remarkable treatment can stop decay in teeth and allows the cavity to heal where many times no filling will be needed at all. When an early decay is detected in a tooth the topical solution is applied for just a minute. It rapidly kills the bacteria that caused the cavity and applies a strong dose of fluoride to start the healing process. The treatment may need to be repeated every six months for up to two years. It is ideal for treating the early decay we find with the Diagnodent laser decay detector and our digital, high resolution x-rays. This procedure can be used at all ages and can be ideal for baby teeth in young children. We at the Baltimore Center for Laser Dentistry have always been committed to using the least invasive procedures when treating dental problems and Advantage Arrest is basically non-invasive. The only disadvantages are that the decay turns dark so it is contraindicated in esthetic areas and larger cavities still need fillings in adult teeth. 
    Early diagnosis and treatment is the key...allowing you to keep healthy teeth that last a lifetime.
  • Fluoride- Over the counter or prescription fluoride treatments help remineralization occur. Fluoride incorporated in the tooth also makes it more acid resistant. We will sometimes apply fluoride varnishes in the office as well. 
  • Calcium - Prescription strength toothpastes are dispensed and used at home. These pastes have calcium that is actiually absorbed by the tooth. Not only does it help harden teeth it improves the appearance too. 
MI Paste helps heal cavities
  • Xylitol- This naturally occurring sweetener has been shown to inhibit decay causing bacteria and promote remineralization.
  • Sealants- Patients with deep pits and fissures on the biting surfaces of their teeth can benefit from sealants. Sealants are not just for kids, as many adults can benefit from them as well.
  • Diet Counseling- Reduction in the frequency of carbohydrate ingestion is crucial to the healing process of decayed teeth. Harmful bacteria need energy  to produce the acid that destroys your enamel and they get from the sugars and starches in your diet.
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