|
Just
Drill It by
Dr. Pietrini
Many times during a golf match, while lining
up a putt, I have had my friend Flip tell me to
"drill it into the hole." I usually
reply that I am trying to enjoy my round of golf
and ask him if he would not refer to the term
"drill." If you are old enough to have
been a dental patient prior to the 1950's, you
would remember the bone-chilling effects of a
belt- driven, slow-speed dental drill with carbon
steel burs that made you think your tooth was
going up in smoke. Since local anesthetics were
seldom used prior to preparing teeth for fillings,
unpleasant visual effects, sounds, odors and pain
are stamped in the memories of previous generations
of dental patients. It was not until the 1960's
that invention of the high-speed drill and more
frequent use of anesthetics helped to shorten
the time of the average dental visit and helped
to reduce the pain that a patient would experience.
In 1959,
as a high school freshman, I remember taking a
reading comprehension test that had a section
on dentistry. The topic was about an unconventional
method of removing decay from teeth with a device
that worked like a sandblaster. As it turns out,
in 1945, Dr. Robert Black wrote an article on
what he called "airbrasion." In 1951,
the S.S. White Company introduced the "Airdent,"
and sold about 2000 of these dental units. At
this time, the typical dental filling was either
silver alloy (amalgam) or gold. Since this system
produced a cavity preparation that was not suitable
for these filling materials, this technology was
lost until the 1990's, when American Dental Technologies
developed the first modern "air abrasion"
unit. Despite the improvements in comfort and
efficiency in dentistry, there was an unending
desire to reduce the need for injections and the
whirring sound of the "drill." For the
first time, a practical alternative to the dental
drill and new approach to cavity preparation was
available.
Air
abrasion is based on the theory of kinetic energy.
The machines perform like mini-sandblasters. An
abrasive powder comes out of a tiny nozzle and
is sprayed towards the stain and decay in the
tooth. Unlike the dental drill, there is no heat
or vibration when air abrasion is used resulting
in little or no discomfort. The cavity preparation
is ideal for placing tooth colored, bonded fillings
for patients of all ages and preventative sealants
for children. Often, treatment can be done without
the need for injections. The drill is still necessary
for removal of old silver and gold fillings, so
in those cases it is usually necessary to give
the patient anesthetic prior to treatment.
Dentists
who are currently using air abrasion have discovered
that they have changed their entire approach in
the area of restorative dentistry. Gone are the
days of "watching" a stained groove
or pit in the tooth. In a matter of seconds, an
easy diagnosis can be made with air abrasion as
to whether a patient needs a sealant or filling
placed.
Fluoride
hardened enamel and high-speed x-ray film can
make detection of some types of decay more difficult.
In my next article, I will discuss how one type
of laser can be used for cavity detection and
another laser can be used to remove decay.
|
