Intercepting Decay

By Dr. Fass

Dentistry is constantly trying to improve treatment modes and is always on the lookout for new products that help to keep treatment minimal. That’s why prevention is always on the top of our list when dealing with dental decay. When decay starts, we like to adhere to minimally invasive ideas. A relatively new and unique product is Icon. It allows us to stop early decay without removing tooth structure, and without needing to numb the tooth or teeth being treated.

Think of the enamel as a sponge-like matrix with calcium and other minerals embedded to give the tooth its strength. When decay first starts, acids from the bacterial plaque dissolve the minerals but leave the matrix intact. In this stage, fluoride will re-mineralize the area and repair the damage. If the plaque remains, more damage is done and some of the matrix will be destroyed. This can sometimes be seen on x-rays or even in the mouth. If the decay hasn’t reached the dentin (or sometimes if it has just reached the dentin), we can use the Icon system to treat the area.

The Icon system consists of special ingredients and devices that allow us to halt the progression of decay. The technical term is infiltration and can be quite effective if done properly.

After isolating the area well to keep it dry, the Icon system uses a special thin film that delivers the chemicals between the teeth, only touching one tooth at a time. First an acid etching gel penetrates the weakened matrix for 2 minutes. This removes any impurities and opens spaces in the area. Then the tooth is washed thoroughly and dried with air and then a drying liquid. Finally, a special acrylic liquid is applied with the film device and allowed to soak in for 3 minutes. This is then hardened with a bonding light and the decay has been removed and completely sealed.

Remember that all of this is accomplished with no numbing and no drilling. Best of all, the tooth has not been weakened since no additional tooth structure has been removed. With careful placement and proper home care this will last a very long time. As with any restorative treatment, prevention of further disease depends upon proper brushing, flossing, use of fluoride, and proper diet.

One of the unique aspects of Icon is that you can’t really see that it’s been done. Since it needs to flow readily into the etched enamel, it cannot have any filler and so it will not show up on future x-rays. It’s up to your dental team to properly record and document when and where they are placed and to compare any areas seen on future x-rays to the older ones. There should not be any change in appearance from the original diagnosis.

There’s an additional side use to the Icon system. When white spots are seen on front teeth, the acid etch and acrylic infiltration combination can literally make them disappear. It changes the way light moves through the enamel and the former white spots are gone. It might even be helpful with some darker or brown spots. Your dentist might suggest testing on one tooth first to see the effectiveness and then do other areas to complete the treatment.

This article was published on 05-12-2023 in The Altamont Enterprise.