Minimally Invasive Approach to Dentistry
We can't regrow teeth, so we need to be sure to treat them well. When dental work is required, saving the maximum amount of tooth structure is essential to provide function and options in the future.
The Bioclear method developed by David Clark in Tacoma Washington updates the techniques and tools for traditional fillings. This method uses the mechanical properties of the filling material - composite resin - to help the tooth remain strong. Essentially the filling is 'shrink wrapped' around the tooth with the goal to mimic natural tooth shape, seal and protect the areas that are more difficult to clean with 'infinity margins'.
For example, a traditional approach to teeth that show cracks is to cover with a crown. While crowns have an important role to play, a Bioclear style filling preserves more tooth, is more affordable, and can delay or prevent the need for more invasive dentistry.
Dental crowns remain an essential tool to repair and protect a tooth. When required, a crown can be made to hold together and preserve a tooth. This is especially important for back chewing molars, or teeth that have had root canal therapy, or when filling materials just aren't strong enough. When Dr Roche prepares a tooth for a crown, she again applies minimal preparation techniques. She often uses a 'vertical' approach, or 'minimal shoulder' technique and recommends strong, long lasting, trouble free materials like gold or a gold base with white porcelain on top. Though these materials may be 'old school', they also have a very long proven track record.
Gaps and Spaces - The Bioclear Method and modern filling materials give us more options for shaping teeth while preserving tooth structure. Filling materials carefully bonded and shaped and polished can give your tooth a new look and shape while protecting the surfaces underneath. The goal is always to create beautiful, easy to clean tooth shapes and surfaces, This includes closing gaps and spaces.
Wear and Attrition - Our teeth work hard for us, and through our lifetime, normal wear to the hard enamel is expected. However, if the softer underlying tooth layer, called dentin, gets exposed, it wears even faster. This can create 'potholes' on your tooth surface that can catch food or be temperature sensitive. Adding back the protection with filling will help preserve and protect.
Erosion and Notching - Sometimes gum recession can expose softer root surface that is prone to wear, resulting in notches that make cleaning even more difficult and can lead to sensitivity and poor esthetics. Filling coverage can protect and improve the situation.
Icon is a resin infiltration technique that requires no or very minimal tooth preparation. Essentially, Icon uses a liquid resin to penetrate the surface of a 'white spot lesion' which might have occurred when the tooth was growing, or might be from early enamel decay. This is a no-freezing, effective surface treatment that still allows for normal tooth whitening in the future.
Silver Diamine Fluoride - SDF
Tooth decay is a process that can be arrested or stopped naturally if the cause is removed and the tooth is not yet too damaged. If the tooth surface isn't broken, keeping it clean it can remineralize the surface and stop the decay. A tool to help us with this is Silver Diamine Fluoride. SDF is a non-invasive cavity-arresting liquid or gel applied with floss and microbrush. It works by soaking into soft decay and killing the bad bacteria and hardening the tooth. It is powerful because it stays on the damaged surface and continues to harden and protect it after application. It also is a good tooth desensitizer. It does need to be reapplied periodically to renew it's effectiveness. SDF can give people a second chance to repair early decay and step up their dental hygiene. It is also helpful for kids as it does not require freezing or drilling, and can sometimes be used to prolong the life of a tooth until it falls out naturally. Nothing is perfect, however, if the situation causing the damage isn't changed, the cavity will eventually progress. If the tooth is broken and impossible to keep clean, a filling will still be needed. Also, where it sinks into the tooth it will stain the cavity-damaged surface a dark black or brown. We love to use SDF as a temporary measure, or in areas where we're not concerned about the staining.
Guardian Dental offers custom made whitening trays for long-term whiter teeth. These trays are soft material and comfortable to wear, with a variety of whitening and desensitizing materials. We offer shorter acting day time, longer acting over night, as well as a long-acting whiting and desensitizing toothpaste that can be used with the trays. We sell refills at low cost, so hang onto those custom trays for a lifetime of whitening and touch-up options.
*Special Note: The above before and after photos are representative of Dr Roche's work, but please note that all dental situations and individuals vary, so results achievable will also vary. No precise 'guarantee' of results or longevity of results can be offered. Please discuss further questions with the dentist. Thank you.