Dr Mark O'Donnell B.D.S
Monday - Thursday
Tuesday and Friday mornings
'No-drill' dentistry stops tooth decay
A University of Sydney study has revealed that tooth decay (dental caries) can be stopped, reversed and prevented without the need for the traditional 'fill and drill' approach that has dominated dental care for decades.
The results of the seven-year study, published in Community Dentistry and Oral Epidemiology, found that the need for fillings was reduced by 30-50% through preventive oral care.
Researchers said that for a long time it was believed that tooth decay was a rapidly progressive phenomenon and the best way to manage it was to identify early decay and remove it immediately. After removing the decay, the affected tooth is then restored with a filling. However, 50 years of research has shown that decay is not always progressive and develops more slowly than previously believed. For example, it takes an average of four to eight years for decay to progress from the tooth's outer layer (enamel) to the inner layer (dentine).
The team in Sydney developed the Caries Management System (CMS) – a set of protocols that cover assessment of decay risk, interpretation of dental x-rays, and specific treatment of early decay (decay that is not yet a cavity).
The CMS involves four aspects:
1. Application of high concentration fluoride varnish by dentists to early decay.
2. Attention to home tooth brushing skills.
3. Restriction of foods containing added sugar.
4. Risk-specific monitoring.
The CMS was tested on high-risk patients with great success, said the researchers, who concluded that a tooth should only be drilled and filled where an actual cavity is already evident. Tests of the CMS in general dental practices confirmed that after seven years, decay risk was substantially reduced among the CMS patients, and their need for fillings was reduced by 30-50% compared to the control group.
No more needles at the dentist
Researchers from the University of São Paulo say that new findings could help improve dental procedures and bring relief to millions of people who are scared of needles. They could also save money and avoid contamination and infection.
To minimise discomfort, dentists use anaesthetics to block pain, which are administered using needles. However, many patients are afraid of these injections, resulting in them postponing and even cancelling visits to the dentist.
For these patients, an additional step is needed: dentists first give them a topical painkiller to reduce the pain – and associated fear – caused by the needle. This can come in the form of a hydrogel, ointment or sprays that can contain lidocaine and prilocaine.
In this study, researchers investigated a way to get these topical anaesthetics into the body more effectively, to see if they could replace needles altogether. They found that applying a tiny electric current – a process called iontophoresis – made the anaesthetics more effective.
The researchers first prepared the anaesthetic hydrogels with a polymer to help them stick to the lining of the mouth. They added two anaesthetic drugs, prilocaine hydrochloride and lidocaine hydrochloride. They found that the anaesthesia was fast acting and long lasting. The electric current made the prilocaine hydrochloride enter the body more effectively, and the permeation of the anaesthetic through the mouth lining increased 12-fold.
The researchers say that this technology has applications not only in dentistry, but also in other areas such as cancer treatment.
They now plan to develop an iontophoretic device to use specifically in the mouth.
Periodontal disease associated with increased breast cancer risk in postmenopausal women
Periodontal (gum) disease is a common condition that has been associated with heart disease, stroke and diabetes. Previous research has found links between periodontal disease and a number of cancers, so researchers wanted to see if there was any relationship with breast cancer.
They monitored 73,737 postmenopausal women enrolled in the Women's Health Initiative Observational Study, none of whom had previous breast cancer. Periodontal disease was reported in 26.1% of the women. Because prior studies have shown that the effects of periodontal disease vary depending on whether a person smokes or not, researchers examined the associations by smoking status.
After a mean follow-up time of 6.7 years, 2,124 women were diagnosed with breast cancer. The researchers found that among all women, the risk of breast cancer was 14% higher in women who had periodontal disease.
Among women who had quit smoking within the past 20 years, those with periodontal disease had a 36% higher risk of breast cancer. Women who were smoking at the time of the study had a 32% higher risk if they had periodontal disease, but the association was not statistically significant. Those who had never smoked or had quit more than 20 years ago had a 6% and 8% increased risk, respectively, if they had periodontal disease.
One possible explanation for the link between periodontal disease and breast cancer is that those bacteria enter the body's circulation and ultimately affect breast tissue. However, further studies are needed to establish a causal link.