Non-Invasive Treatment
Non-Invasive Treatment Icon from DMG is useful when you have an early non-cavitated lesion and wish to avoid opening it up. I feel that the classification is slightly misleading as in my mind, it is non-invasive. Cochrane report of a few years back highlighted the use of such a product for micr-invasive treatment and concluded that they "significantly reduced the odds of lesion progression". To demonstrate this treatment to our patients, I think using 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, PAD+ has been available for several years. It's a Photo Activated Disinfection system that eliminates bacterial and fungal infections in many dental treatments. The technology allows us to eradicate cariogenic bacteria effectively and efficiently at one visit with no required invasive procedures. 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 is essential. We need to consider the use briefly and need for appliance therapy, as mentioned above.
Often we are presented with cases where patients have pulpitis, and the cause could be bruxing that may occur either day or night. The latter group often contact first thing in the morning, complaining of having been awoken during the night with toothache. It is present in all age groups and is sometimes stress-related. One can certainly see many more stress-related issues with our current life patterns. We should risk assessing for this as well as caries. Appliance therapy could avoid the "filling /extraction cycle". Even the use of a simple soft gum shield to confirm the diagnosis to both the patient and clinician. An intra oral camera could highlight the faceting on teeth that sometimes even dentists fail to spot.
