Preventive and Minimal Intervention Dentistry
The relatively recent concept of “Minimal Intervention (MI) dentistry” has assimilated a range of preventive disease management approaches. MI dentistry, integrates modern methods of ‘minimalist’ management of enamel demineralization lesions, including those related to caries and erosive demineralisation lesions. This is in contrast to the traditional surgical approach of drilling and filling, which treats the observable clinical signs of the disease, with little or no emphasis on prevention, rather than dealing with the underlying causes and processes of the active disease or disorder.
Minimal Intervention dentistry has evolved as a consequence of the increasing understanding of the caries and erosion processes, improved risk assessment techniques, the increased availability of new detection/diagnostic tools, as well as developments in remineralisation technologies, adhesive materials and bonding techniques. It is now recognized that “early stage” – demineralized but non-cavitated – enamel can be “healed” and that the surgical approach to treatment (along with “the extension for prevention”), as proposed by Black over a century ago, is no longer appropriate. ¹
The CALCIVIS minimal intervention principle is simple:
- Screen potential demineralization sites (ICDAS code 1, 2 & 3) lesions using accepted risk assessment methods. (Examples include pit and fissure sites, buccal, lingual and palatal surfaces, sites adjacent to the margins of existing restorations, as well as around orthodontic brackets)
- Perform a CALCIVIS imaging system ‘capture’ of identified sites to aid diagnosis of active demineralization, share and discuss the results chair side with the patient or carer.
- Recommend patient actions to minimise identified risk factors, thus aiding the prevention of further demineralization.
- Treat identified active lesions using (non-surgical) reparative mineralizing materials and/or sealing techniques to aid repair of enamel structure and help protect against further damage.
- Monitor success at follow-up using the CALCIVIS imaging system
Implementing CALCIVIS minimal intervention effectively involves all the above preventive approach elements being integrated fully.
1. Douglas et al: Rationale and Evidence for the International Caries Detection and Assessment System (ICDAS II)