Is Tooth Drilling Necessary in Dental Treatment?

Does the high-pitched whine of the dentist's drill send shivers down your spine? For some patients, the fear that they may need to have a tooth drilled makes them avoid visiting the dentist, sometimes for months at a time. But putting off treatment often means that a minor dental problem turns into something more serious. Tooth drilling is a necessary part of filling a cavity, but new technologies are on the way that could make this spine-tingling procedure a thing of the past.

The Cavity Filling Procedure

Dentists drill teeth to remove decayed enamel and dentin before filling a cavity. Before beginning to drill, the dentist numbs the area with a local anesthetic, if necessary. They then use a high-speed drill to remove the decayed tooth enamel in the area of the cavity. Next, they may switch to a lower speed drill to remove the dentin, which is softer than enamel.

After removing all the decayed material, the dentist shapes the cavity so that it's ready to receive the filling. At this point, the drilling is over, but the dentist may continue to work in the cavity, preparing it so that the tooth pulp is protected, adding material that releases fluoride to protect the tooth from further decay or etching the cavity to help the filling adhere to it.

New Tooth Drilling Technologies

For patients who dread having their teeth drilled, hope is on the horizon. Plasma jets, lasers and resin infiltration treatments are some of the rising alternatives to tooth drilling that dentists may be able to offer in the near future.

  • Plasma is a state of matter that isn't a gas, liquid or solid. Scientists have found that plasma technologies can destroy mouth bacteria and remove infected tooth tissue. Plasma jets have already been successfully used in place of a drill in treatment of cavities, according to Clinical Plasma Medicine.
  • Lasers are already popular in several areas of dental treatment, according to Stanford Children's Health. Lasers are used to harden composite fillings, light up and locate small areas of tooth decay, destroy bacteria in the root canal and operate on gums and cysts. In addition, lasers can remove areas of decay and prepare teeth for fillings, but only for very small cavities.
  • Resin infiltration is a new treatment that avoids the necessity of drilling to reach decay between teeth. Dental researchers at the University of Alabama at Birmingham pioneered the latest clinical trials in the United States, according to Medical XPress, but the technique has not yet moved from lab testing into every dentist's office. To seal teeth with resin, a perforated sheet is pushed between the teeth, and a gel that cleans out decay and prepares the enamel and dentin surface is applied through the sheet. The dentist then forces the resin through the sheet, and the resin settles into the cavities. Finally, the dentist shines a light on the resin to cure, or harden, it.

Preventing Decay in the First Place

The best way to avoid a numbing and drilling session in the chair (but not your dentist) is to keep up with regular oral hygiene. Flossing at least once a day and brushing twice daily with a toothpaste containing fluoride can help prevent the plaque that leads to cavities.

Tooth drilling is often a necessary part of cavity treatment. If the prospect makes you uncomfortable, don't avoid visiting your dentist — tell them about your fears! They can explain exactly what will happen and why and help you calm your nerves. Soon, they may also be able to suggest an alternative to the dentist's drill.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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What to Expect During a FILLING

  1. Local anesthesia – at the beginning of your filling procedure, you may be given local anesthesia to numb the area around the tooth.

  2. Tooth decay removal – then the dentist will cut through the enamel using a drill to remove any decay. After the dentist removes the decay, the dentist will shape the space to ready it for the filling.

  3. Etching – for a bonded filling your dentist will etch the tooth with an acid gel before placing the filling.

  4. Resin application – for certain types of fillings the dentist will layer on the resin and harden it using a bright light. This makes it strong.

  5. Polishing – after the filling has been placed, your dentist will polish the tooth.