Darren Gardner DDS, Provo Dentist

Minimally Invasive Dentistry

My goal as a dentist is to help our patients keep their natural teeth for their whole lifetime.  One way we help our patients accomplish this is through minimally invasive dentistry.

Minimally invasive dentistry simply means that we use modern, advanced techniques when we restore your teeth to preserve the maximum amount of healthy tooth structure possible.  Treating teeth with minimal drilling is less traumatic to the pulp and reduces the risk for root canal treatment in the future.  The bottom line is that minimally invasive techniques help prevent future crowns, root canals, and extractions so you can  keep your natural smile for a lifetime.

A large part of minimally invasive dentistry is finding problems and treating them while they are small.  Tooth structure, once it is destroyed, can't grow back or heal itself.  When it is gone, it is gone!  Tooth structure is destroyed by decay, tooth breakage, tooth wear from grinding, erosion from acidic foods and drinks, preparing teeth for full crowns, or removing excessive tooth structure for other dental restorations.  All of these will affect how long your teeth will last.      

In addition, dental restorations have a limited lifetime and may require replacement several times in a person's life. Each time a restoration is replaced, more tooth structure is removed and there is less tooth structure to work with.  A restoration can be replaced until there isn't enough tooth to restore, and then the tooth must be extracted.  This is why we routinely do onlays and 3/4 crowns rather than full crowns.  Onlays and 3/4 crowns make your tooth last longer by leaving more natural tooth structure to be restored again in the future. 

Tooth with a cusp fracture treated conservatively with an onlay rather than a full crown

Onlays and 3/4 crowns look more natural and strengthen the tooth without removing excessive tooth structure

Most dentists treat all weakened teeth by grinding down the whole tooth for a full crown

Finding decay while it is small keeps the tooth strong and prevents future crowns and root canals.  If decay is removed and restored with a small filling, it can be replaced with another small filling, and a crown can be put off until much later if one becomes necessary.  If decay is neglected, however, the tooth will become weakened and need a crown sooner than if the decay were removed while it was small.  Many times, a tooth with a deep and large filling will also become infected and need root canal treatment after a few years.  

Detecting decay while it is small prevents wide and deep fillings which weaken the tooth.  High power magnification helps to identify areas that normally get overlooked.

While the advanced techniques we use are a big part of minimally invasive dentistry, prevention of dental disease is the foundation. We strive to prevent decay and gum disease through regular 6 month cleanings, educating our patients about preventing cavities and gum disease, recommending xylitol and fluoride to reverse surface level cavities, and counseling about diet and other habits that are causing decay or other problems. 

We preserve tooth structure by:

• encouraging proper diet and home care to prevent tooth decay and gum disease
• diagnosing and treating decay before it has caused significant structural damage to the tooth
• diagnosing structurally compromised teeth that are prone to fracture and recommending an onlay or 3/4 crown to strengthen them. 
• Doing onlays, 3/4 crowns, or veneers instead of full crowns, when possible.
• using high power magnification for better vision.  This helps diagnose cavities and cracks with more accuracy and allows us to keep our preparations small, without the need to remove tooth structure unnecessarily to be able to see. 
• doing high quality dental restorations that don't need to be replaced as frequently
• recommending implant restorations instead of bridges to prevent grinding down healthy teeth adjacent to the missing tooth
• encouraging orthodontic alignment of teeth rather than crowning teeth to align them
• recommending night guards to prevent excessive tooth wear and fractures from clenching and grinding in your sleep
• making patients aware of tooth erosion caused by acidic foods and drinks
• diagnosing and treating gum disease before the bone deteriorates around the teeth
• doing a thorough exam every six months checking for gum disease, decay, and fracturing teeth