Fillings without a drill? Air Abrasion technology in minimally invasive dental medicine
No More Drill? I’m thrilled!
Many people fear the sound of the dental drill (technically called a handpiece) when they visit the dentist. These drills are used to remove cavities, old fillings, prepare teeth for crowns, veneers, etc. What if I told you that there exists a technology that doesn’t require the whining drill to accomplish some of these procedures? No, I’m not talking lasers, though they do exist and can circumvent the drill sometimes. I’m referring to a technology known as air abrasion.
Air abrasion is basically a tiny little wand that propels miniscule particles of a substance known as aluminum oxide (27 microns in diameter; 27/1,000 of a millimeter wide) under high pressure. These particles use kinetic energy rather than mechanical energy (as a bur spun by a drill does) to gently “blast away” small cavities. The neatest thing of all is that many smaller cavities can be removed painlessly with no local anesthetic! This is possible because the particles generate very little friction when they gently remove the decayed tooth structure. Burs generate huge amounts of friction, which heats up the tooth structure. This is why local anesthetic is usually required when a conventional drill and bur are used. Less friction with air abrasion spells no pain and no anesthetic the majority of the time!
Air abrasion is akin to a sandblaster. If you have ever watched some one sandblasting wood or stone, there is no cracking along the perimeter of the cut. This is possible due to the kinetic energy produced by the sandblaster, which generates much less friction than a drill. The normal drill and bur are akin to an electric drill and a screw. Have you ever carefully watched a drill sink a screw into a piece of wood? Numerous cracks radiate out from the center of the hole that the screw is creating as it is drilled into place. This is what happens when burs hit teeth. They tend to radiate cracks outward from the center, which can turn into problems for the tooth over the years as the cracks weaken what is left of the tooth.
Air abrasion is typically used to remove small cavities. Anything medium to large generally requires the use of the dental handpiece and the burs as the softer, larger cavities are not amenable to removal via the tiny particles under pressure.White or composite fillings are bonded into these very small and conservative holes. This bonding process is typically painless and only takes a few minutes.
Air abrasion technology being used to gently “puff away” a small cavity of a permanent molar tooth. Kinetic rather than mechanical energy is utilized to remove the problem, usually without the need for anesthesia or a drill.
Advantages of Air Abrasion:
- Allows us to treat multiple areas of the mouth in the same visit since little to no anesthesia is required
- Greatly reduces the need for anesthesia for smaller fillings
- No pressure, sound, heat or vibration is generated
- Minimally invasive; less tooth structure is removed than with normal conventional drilling
- Reduces chipping and micro-fracturing of tooth structure, preserving more healthy tooth structure
- Allows the dentist to penetrate porcelain crowns as needed without destroying the old crown, as oftentimes happens with the conventional drill bit
- Can remove old composite white fillings, often without any anesthesia
Disadvantages of Air Abrasion:
- Larger, softer cavities are not amenable to this modality as the powder will not remove grossly softened tooth structure
- Reserved for the use of smaller cavities
- Will not remove old silver amalgam fillings