Minimal intervention dentistry

Minimal intervention dentistry is a modern dental practice designed around the principal aim of preservation of as much of the natural tooth structure as possible. It uses a disease-centric philosophy that directs attention to first control and management of the disease that causes tooth decay—dental caries—and then to relief of the residual symptoms it has left behind—the decayed teeth. The approach uses similar principles for prevention of future caries, and is intended to be a complete management solution for tooth decay. Classical restorative dentistry has traditionally followed the century-old approach of GV Black in classification and treatment of tooth decay. This was based on very limited knowledge at the time about the pathology of the underlying dental caries disease, and the need to specially prepare a cavity to repair a lesion (decayed area) with the limited available materials. Therefore, the only approach was to treat the symptoms—to remove the decay and restore the tooth surgically. Modern science has since allowed for better understanding of the pathology, thus opening the door for new methodologies and approaches to treatment. The practice of minimal intervention dentistry was designed to utilise these new possibilities by implementing a disease-centric philosophy to management of tooth decay. While advances in dental science are of course used in mainstream dental practice, MI dentistry has redesigned the treatment guidelines beginning with a new classification of caries lesions. This classification was intended to reflect the possibility of curing the disease and remineralising (hardening) early lesions before irreversible damage has been done. It was first published by Mount and Hume in 1997 and has subsequently been revised. Some see minimally invasive dentistry as merely a philosophical change, but since the practice has been in mainstream discussion in the late 1990s, it has acquired some respectable international academic backing.