I am a dentist that has worked in practice for nearly 40 years. I am not an academic nor a specialist but a dentist that feels passionately and enthusiastically about MID. I have lectured in the UK and abroad running a large number of courses on this subject. At this time of a real crisis with the COVID virus I feel that it could be of real benefit to help us address some of the major hurdles that lie ahead. We should look at how we can overcome some of those hurdles and maximise the use of materials and techniques. These are available right now and could be implemented straight away thus allowing some kind of normality to return and removing some of the financially uncertainty. Mostly I have described technique that do not involve drilling nor the use of aerosol. I do not feel that science / dentistry is as clear cut and as black and white with no grey areas in between. Pulpitis cannot be that clearly defined as with that shown in a flow charts in the guidelines from OCDO. I firmly believe that we have other routes that we could follow avoiding invasive therapy that results in the dreaded cycle of ever increasing cavity size / RCT and extraction, the “filling/extraction cycle”. MID offers us a great opportunity to give our patients treatment that results in less biological and economic cost. This philosophy can bring about a sea change in their care. It is our duty “to think outside the box” looking for the best treatment that is available to them, they do not deserve anything less. I shall lay out the guidelines that I feel could help to be the basis for implementation to all practices and clinics as a matter or urgency. I felt at the time of starting my lectures and courses that it should be embraced as the basis of all dentistry. Dentistry has been reset. It is even more relevant and important now starting from when patients present at our practices / clinics. It is crucial to risk assess at every stage and level whilst keeping the patient FULLY informed with appropriate consent being noted.
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