Tooth decay can be reversed without drilling and filling

Preventative oral care can reduce the need for unpleasant dental drilling and filling by 30-50 percent, says a study.

The findings suggest that tooth decay or 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.

"It is unnecessary for patients to have fillings because they are not required in many cases of dental decay," said the study's lead author Wendell Evans, associate professor at University of Sydney in Australia.

"This research signals the need for a major shift in the way tooth decay is managed by dentists. Our study shows that a preventative approach has major benefits compared to current practice," Evans said.

The researchers said that application of high concentration fluoride varnish by dentists to the sites of early decay, attention to home tooth brushing skills, restriction of between-meal snacks and beverages containing added sugar, and risk-specific monitoring can help prevent tooth decay.

"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 in order to prevent a tooth surface from breaking up into cavities. After removing the decay, the affected tooth is then restored with a filling material -- this process is sometimes referred to as 'drilling and filling'," Evans explained.

"However, 50 years of research studies have shown that decay is not always progressive and develops more slowly than was 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)," Evans noted.

"That is plenty of time for the decay to be detected and treated before it becomes a cavity and requires a filling," he said.

Evans said that a tooth should be only be drilled and filled where an actual hole-in-the-tooth (cavity) is already evident.

The study was published in the journal Community Dentistry and Oral Epidemiology.