Abstract

This lecture is focused on the Medical Management of Caries (MMC), no shots, drills or pain for children and adults. In it I suggest  MMC as a first measure to control caries for  all patients of all ages in every venue and for all populations especially in places where tooth decay, destruction and pain adds insult to the injury of  displaced and homeless people with limited dental access- which is everywhere. 

This lecture is excerpted in part from what I teach to NYU’s 400 dental residents worldwide with the specific objective of “Changing Dentistry” from “Drill and Fill” to “Seal and Heal” because current scientific evidence shows that bacteria that cause caries  should not be  attempted to be drilled away because that has been proven not to work  and because  we now know decay-causing bacteria can be arrested  from progressing and tooth destruction can be restored simultaneously  using medicines  like 38% SDF instead of drills. That’s more effective, more humane and more preventive of further tooth decay than what needles and drills provide.  When money, time and patient behavior allow, more can  always be done, if indicated. 

This new approach to tooth decay and pain has the potential to “change dentistry”  especially for populations in dental crisis. The new, medical approach to controlling dental caries is far more cost-effective with outcomes of improved school attendance and improved quality of life for children and adults. Changing dentistry even further, the American Medical Assoc just created a CPT reimbursement code for medical teams to apply 38% SDF which treats and prevents caries far upstream of the disease simply because medical teams see our dental patients (at medical well baby exams and immunizations) long before a child’s first dental exam. “Dry, Apply, Bye” is the theme of my talk because it represents how simple it is to apply 38% SDF that arrests caries. MMC first - because it’s safe, simple, affordable, de-sensitizing and painless.

Learning Objectives

• To understand the concepts of the Medical Management of Caries and how it differs from the surgical management of caries. 
• To understand SDF chemistry and its mechanisms of actions. 
• To see, hear and integrate evidence-based data for SDF effectiveness and safety.
• To learn the best  way to message staff, parents and patients about SDF+FV applications to control caries.
• To learn how to prevent ER visits and to stop referring for unnecessary DGA and in-office sedation by using SDF instead as a painless, effective, well-tolerated first measure for caries control.

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