Killing the Drilling: How This New Technology Could Impact Dentistry

Dental phobia is real. One study showed that up to 75 percent of Americans have postponed needed dental treatment from fear of drilling or pain. This leads to all kinds of complications, from infections to tooth loss.

Many dentists are addressing dental phobia and trying to reach out to people who are too afraid to come in for care. Some have their dental assistants help patients relax with deep breathing techniques during treatment. Others offer "sedation dentistry," where patients are given pharmacological agents, either by ingesting a pill or inhaling a gas, to overcome their fear of the drill. These medical therapies, while often effective, can add significantly to the cost of dental care.

Dental researchers in London have developed a new method of treating cavities that may revolutionize dentistry – and remove the pain and fear that accompanies a trip to the dentist. It is called Electrically Accelerated and Enhanced Remineralization, or EAER, and it just may kill the drill for all but the most complicated dental treatments. 

What Is Electrically Accelerated and Enhanced Remineralization (EAER)?

Electrically Accelerated and Enhanced Remineralization

Image via Flickr by Joseph Morris

To understand EAER, it helps to understand cavities and how they form. Teeth are coated with a protective mineral shield called enamel. When plaque builds up on teeth and is not brushed away, it produces acids that relentlessly attack enamel and causes it to become porous. A cavity occurs when enough enamel is dissolved to form a hole and the underlying tooth begins to decay.

Teeth have an inherent ability to repair themselves by replacing lost minerals with fluoride, for example, or other minerals that naturally occur in saliva. However, the process happens too slowly to reverse decay.

Traditional cavity treatment involves drilling out the decayed and damaged portions of the tooth and replacing it with an amalgam or composite resin filling. The researchers at King's College set out to discover a way to accelerate the tooth's own remineralization process and eliminate the need for invasive drilling. 

Ultimately, the dental researchers discovered a two-step process that involves preparing the surface of the tooth followed by pushing minerals into the tooth using tiny painless electric currents. The use of electrical currents to drive minerals deep into the tooth and accelerate natural remineralization is the basis of EAER

How Does EAER Compare to Traditional Methods of Treating Cavities?

dentists performing mouth surgery

Image via Flickr by Naval Surface Warriors

The standard practice of drilling out the damaged portions of a tooth and replacing it with a filling material involves a number of disadvantages. Foremost, of course, many people have an involuntary fear of the injections, sounds, and smells associated with the drill.

Amalgam and resin fillings also need to be replaced, usually between seven and 12 years, due to shrinkage or new cavities beneath or adjacent to the treated surface. In addition, the mercury in silver amalgam has been linked to Chronic Fatigue Syndrome-like symptoms and the World Health Organization faults dental amalgam for over half of the mercury emissions into the environment. 

The developers of EAER say that enhanced remineralization will take about the same amount of time as drilling and filling, and cost the same or less, but that is where the similarities end. EAER is completely painless, and it is accomplished with a small "healing hand piece" that is placed on the damaged surface of the tooth for a short period. No foreign materials are introduced into the patient's body, only naturally occurring minerals.

Unlike drilling and filling, no healthy portions of the tooth are destroyed to prepare the tooth for repair; the tooth maintains its integrity. Teeth treated with EAER are stronger after treatment. EAER actually helps fight decay.

Also, treatment with EAER can concurrently whiten teeth without the risks of bleaching products, making it a great incentive for patients who might otherwise postpone treatment. 

What Does EAER Mean for the Future of Dentistry?

According to the World Health Organization, nearly 100 percent of adults and 75 percent of school-aged children globally have cavities that need treatment. EAER has the potential to be a more cost-effective and long-lasting solution for dental caries, especially for adults and children treated by NGOs like Dentistry Without Borders.

Teeth treated with EAER don't have any foreign filling materials that need to be replaced over time. EAER may be an ideal treatment option for adults and children in developing countries with limited access to regular dental treatment since remineralized teeth maintain their integrity and become stronger after EAER.

Enhanced remineralization treatment may also be the pain-free, drill-free alternative that attracts patients who put off care due to dental phobia. With EAER, there is no need for multiple painful anesthetic injections or loud and invasive drilling. When patients discover that comfortable, pain-free treatment is available for cavities, the researchers speculate that they will be more likely to return to the dentist for treatment of more dangerous conditions like gum disease. Fear of the drill is one of the most frequently cited reasons that patients fear dental care. 

When Will EAER Be Available?

Professor Nigel Pitts of the King's College London Dental Institute says that the technology should be available in three years in the United Kingdom. Reminova, the spin-off company formed by the dental researchers, is aggressively pursuing the commercialization of the technology. EAER is also supported and promoted by London mayor Boris Johnson as part of the MedCity initiative.

In the United States, the technology is regulated by the FDA, which has more demanding requirements than Britain's regulatory bodies. However, Pitts says that he and his team are working closely with international organizations, including the FDA, to promote acceptance of the technology.

While the concept of remineralization has been a viable research topic since the 1980s, EAER is the first solution to harness technology to accomplish natural healing and tooth remineralization as a treatment for dental caries. This painless process could revolutionize dentistry and dental care as the world knows it. The dental industry is looking forward to innovative ways to treat patients and make their teeth healthier and stronger. 

Contributed to by Kim Evans

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