MID: my journey from “drill & fill” to “no needle, no drill”. Paradigm shift in pediatric dentistry
Pediatric dentistry is still often very similar to adult dentistry, that is to say mainly restorative.
The bases are syringe, needle and turbine. We have been formatted to “drill and fill”.
The common idea that the entire carious tissue must be removed leads to unpleasant procedures.
Even if many children are cooperative and accept what we do, some – more and more – are not able to tolerate our treatments and the visits are proving difficult for them … and for the practitioner, in a context of explosion of carious disease (omnipresence of sugar).
We will explore alternative approaches for the treatment of carious disease, most often “no needle – no drill”. We will challenge certain dogmas and offer child-friendly options that will not only make visits more enjoyable, but also drastically reduce the need for sedation and general anesthesia.
ART (atraumatic restorative treament), HALL, NRCC (non-restorative cavity control) techniques will be discussed.
As well as the return of silver compounds including SDF (silver diammine fluoride) which, along with glassionomer cement, led to the concept of “medical management of caries” (MMC) and SMART dentistry.
The local use of polyvidone iodine will be discussed.
The very simple but innovative concept of “gentle hand burs” will be discussed.
Phobic adults and patients with special needs are also good candidates.
These procedures are not only more suitable for children and frail patients but also produce little or NO AEROSOLS.