Non-Invasive Treatment Icon from DMG is useful when you have an early non cavitated lesion and wish to avoid having to open it up. Cochrane report of a few years back highlighted the use of such a product for the micr-invasive treatment and concluded that they “ significantly reduced the odds of lesion progression”. I feel that the classification is slightly misleading as in my mind it is non-invasive. To demonstrate this treatment to our patients I think that the use of an intraoral camera to show the patient the damaged tooth and explain how this revolutionary treatment and others could avoid the need for future fillings is very important. aPDT or antimicrobial photodynamic therapy using, for example, the PAD+ has been available for a number of years. This is Photo Activated Disinfection system that eliminates bacterial and fungal infections in a large number of dental treatments. The technology allows us to effectively and efficiently eradicate cariogenic bacteria at one visit with no invasive procedures being required. It can be used in conduction with other chemo-mechanical disinfection for caries, perio, implants, dry sockets and reRCT. As with all forms of treatment thorough note taking is required and the appropriate follow up / review period essential. We need briefly to consider the use and need for appliance therapy as mentioned above.
Often we are presented with cases where patients have pulpitis and that the cause could be due to bruxing that maybe occurring it either day or night time. The latter group often phoning first thing in the morning complaining of having been awoken in the night with toothache. It is present in all age groups and sometimes stress related. One can certainly see a lot more stress related issues with our current life patterns. We should risk assess for this as well as caries. Appliance therapy could avoid the “ filling /extraction cycle”. Even the use a simple soft gum shield to confirm the diagnosis to both the patient and clinician. An intra oral camera again could highlight the faceting on teeth that sometimes even we dentist fail to spot.