Minimally invasive dentistry. Clinical applications.

16-" Doctor, do I have to lose the tooth? " " Do I have to have a crown? I'd rather not cut the tooth down like the last one. " " I hate to have my nice teeth reduced just to replace one tooth. " You have probably heard each of these comments many times. In each case, a decision had to be made as to what treatment to recommend. Every dentist has periodically practiced minimally invasive dentistry (MID) by doing " less " to get a good result. The question is, do you consider being less invasive for each dental procedure? Is less more? Should every endodontically treated tooth be crowned? Do all 6-to 7-mm pockets need surgery? When are veneers more appropriate than orthodontics? Is smaller always better? These questions lead us to think on a daily basis about how we are going to practice dentistry. In this article, I would like to call attention to some of the approaches that lend themselves to a changing focus toward MID. Each case presented could have been treated in another way. However, in each case, the less invasive procedure was chosen. Consider your own approach to dental care and see if you can preserve more by invading less. MID (or Microdentistry) is a mindset Every patient deserves to have the most recently advocated care that results in the most predictable outcome. The outcome includes the concept of longevity. When one considers that a small filling preserves strength in a tooth, it seems obvious that a small filling would be the treatment of choice where appropriate. However, this is not always the case. To do less is more, especially if one constantly has a mindset that sees every treatment plan as an opportunity to be less invasive. As an example, every root canal that saves a tooth is less invasive and more preserving than an extraction. Every implant placed between virgin teeth is more beneficial and predictable than a bridge. Every onlay preserves tooth structure compared to a crown. Every tunnel prep preserves a marginal ridge. Each time a patient presents with a problem, whether it be a small area of decay or an edentulous ridge, an opportunity presents to perform the least invasive procedure for a good outcome. When the focus is on using technology to treat each condition, the outcome can be further enhanced. For example, detecting decay can …