Are Dentists Unnecessarily Drilling Your Teeth?

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In spite of research for more than 30 years that implies the opposite, dentists continue to drill and fill tooth surfaces that may have the ability to heal which leads to costly dental treatment.

In a randomized and objective controlled trial that was conducted by the University of Sydney Dental School, the cost effectiveness and efficacy of a non invasive approach to the management of dental care was studied in a variety of private Australian dental practices.

This non invasive program was shown to be effective in reducing the incidence of recurrent and new tooth decay during the 3 years that the study was conducted by over 40%.

These results were independent of the previous history of dental care, fluoride history, medical status, gender, or age in a population of patients that attended the treatment in private dental practices.

In addition, it would appear that in the patients who were at medium to high chance of having dental decay, the program was rather cost effective when it was compared to existing dental care practice.

The prevention of care has been, and remains, a major goal for the dental profession. A recent study, Modeling the long term cost effectiveness of the Care Management System in an Australian population, that was published in Value in Health, highlights the disparity between routine dental clinical practice and a model of care which is evidence based in terms of prevention intervention and diagnosis.

That is what the co author of the study, Associate Professor Wendell Evans has stated that it is unfortunate that dental care has moved towards a more interventionist model. The current remuneration process and payment rebate is weighted towards rewarding crowns fitted and fillings performed. The newly adopted system for early decay diagnosis has opened opportunities for the prevention of cavities.

The shift in resources towards the more expensive cosmetic procedures, while understandable, is creating a resource issue that will require the collaboration of the researchers, dental funds, patients, and professionals. This study is the first step towards defining and hopefully addressing the problem. This topic will be discussed in a future issue of Value in Health.