It's the part of dentistry that most of us dread. Drilling. It always seems like there needs to be drilling. A cavity is a hole, right? Can't the dentist just fill it? Well, no. There is a little more to it. Let's discuss why the dentist always seems to be drilling your teeth.
Why do dentists drill cavities?
The quick answer? To clean them out before filling them. To understand it properly you need to know a little more about tooth decay. What happens, in a nutshell, is that small particles of food and sugar react to the combination of bacteria and saliva in your mouth and then you've got an acidic reaction. The enamel, which is the protective coating of your teeth, is eroded from the acid produced during this reaction and if this occurs at a rate faster than your teeth can replace it. then blammo, you've got a cavity. The cavity isn't just a hole, either. Packed with decaying material, if it's not dealt with then it will erode your tooth further until eventually it must be shaved down for a crown or simply removed. Cavity drilling is unpleasant but necessary to widen that cavity opening and clear out the debris. A tooth drill is the best means for this, hands down. So, what happens after this?
My cavity was small. Would the dentist drill his own tooth for a small cavity?
Well, he would probably get a colleague to do it. Fumbling around with a drill, a mirror, and anesthetic would be a recipe for the Darwin awards, but essentially, yes. In cases where a cavity is very small it still needs to be cleaned and there needs to be enough working space to fill it. Some cavities are even deep inside a tooth and so your dentist has to drill inside to get to it.
So, what other choices are there? Drilling has always been rather unpopular, but for the most part a drill to a dentist is the same as a hammer is to a carpenter. Simply necessary. There are some technologies that are emerging, however. Some are already in use while others are still going through the lengthy process of approval but should be coming soon to a clinic near you in no time. Let's discuss a few of those.
Alternatives to drilling
You will be happy to know that one day standard drilling might be a thing of the past. There are various alternatives in development that may one day replace the standard drilling procedure. Some examples of alternative treatment are as follows:
- Lasers - Already in use in a number of clinics, lasers can do more than just drill into things. Lasers may be used for surgical operation, for instance, or in a 'search and destroy' type of application for small areas of tooth decay. Also effective for hardening a composite filling, who knows what further applications those clever dentists will find? We just wish that the lasers kept the 'pew pew' sound from Star Wars. Wouldn't that be fun?
- Air abrasion - also called 'particle abrasion', this technique has been around for some time. However, recent advances in thr control factor involving this technique have opened up the dental venue as an area that can benefit from this technology. So, what is Air abrasion? Air abrasion is a technique where tiny, controlled streams of particles are directed at an area of decay in the tooth. This allows for removal of the nasty bits while retaining more of your teeth than is currently possible with a standard drill. As a bonus, this technique doesn't employed that whining pitch of the drill that we've all come to fear and doesn't even require anesthesia some of the times it is employed. Quite fascinating, no? The downsides? Well, it doesn't work on larger cavities and the tooth has to be isolated inside your mouth to avoid the patient swallowing lots of dust. A specialized pump also needs to be utilized to avoid creating the equivalent of a mini-sandstorm in the office, .
- Resin Infiltration - This is a pretty neat technique used to heal the spots between your teeth when they are succumbing to decay . A perforated sheet is placed in-between the teeth along with a cleaning gel that prepares the tooth for the bonding process. Once in place and cleaned, a resin is forced into the teeth and then hardened with the application of light. While this technique hasn't yet left the labs it is something that you will surely be seeing in practice soon.
“It also happens to have a stimulating effect on the stem cells... ”
- Plasma - Scientists have found that certain applications of plasma are good for destroying bacteria and the removal of infected tooth tissue as well. This is another up-and-coming technology that may be utilized in your dental clinic soon!
- Tideglusib(stem cell stimulation/Alzheimer's drug) - While this alternative wouldn't completely erase the need for some sort of drilling procedure(maybe we can use lasers!) it is still quite interesting and promising. Tideglusib is a drug that is being looked into for Alzheimer's disease. Scientists have discovered that it also happens to have a stimulating effect on the stem cells that reside inside your teeth. By introducing the drug within a tooth they were able to stimulate the body's ability to heal itself. Specifically, in this case, the tooth begins producing special tooth-cells called ordontoblasts. This increased the production of dentin, the hard, bony inner-tissue beneath the enamel that makes up most of your tooth. So far this has only been demonstrated in mice but folks, we are looking at regeneration here. This is pretty fantastic.
Now you know why dentistry still employs the drill even when a cavity is smaller than the space that the drill will make. It's simply a matter of cleaning out the workspace, so to speak. So next time that you visit the dentist be sympathetic... and ask if they have lasers!