DATE: Aug 17, 2016 
AUTHOR: Amber Metro-Sanchez

Envision a scenario where your patient is told by the dentist that he or she has a small area of dental caries, but that it doesn't need a filling. "No drill dentistry" can dramatically change your patient's mindset about what it means to go to the dentist. Less drilling and fewer fillings sounds wonderful to everyone. Instead, you can work with your patient to reverse dental caries by treating it early. Here are some facts about this method of treating your patients.

Research Behind the Concept

No drill dentistry is a minimally invasive approach that focuses on prevention and the preservation of tooth surfaces. The key to this method is reversing and monitoring areas of dental caries when they are found early, rather than simply removing every carious lesion that is found.

It had been a long-held belief that dental caries progresses quickly. However, according to new research by the University of Sydney, the caries process can take anywhere from four to eight years to reach the dentin from the outer surface of the enamel. The Australian study focused on the hypothesis that the tooth should only be drilled and filled in situations where cavitation is already evident. Otherwise, the area can be treated with preventive measures.

How to Implement the Caries Management System

As a result of the study, Professor Wendell Evans and his research team created a caries management system (CMS). This four-step plan helps dental hygienists prevent any further progression of the existing carious lesion by focusing on preventative measures that allow your patient to take control of his or her oral health. The CMS steps are as follows:

  1. Apply a high concentration fluoride varnish to sites of early dental caries. Colgate® PreviDent® Varnish (5% Sodium Fluoride - Rx Only) is an excellent example of a product to help remineralize these vulnerable areas.
  2. Encourage patients to pay special attention to their home care, especially effective tooth brushing.
  3. Advise patients to limit between-meal snacking and sugar-sweetened beverages.
  4. Monitor each patient for his or her specific risk.

As a dental hygienist, you are essential to the caries management system. Treating your patients on a routine basis ensures that the affected area can be treated and monitored regularly, and you can customize your patient's oral health education to his or her specific needs in order to address any problem areas.

Effectiveness of No Drill Dentistry

The results of a seven-year study, published in Community Dentistry and Oral Epidemiology, show that early caries can be arrested and reversed by remineralizing the affected tooth structure with the caries management system. 5,000 ppm fluoride can help remineralize root caries and help reverse white spots. With dental caries that extends into the dentin, traditional fillings may still be required, but earlier stages are well-suited for a more conservative approach. And, of course, this "no drill" method is dependent upon your dental practice working as a team with your patients for it to be effective.

Dentistry has always been defined by the dreaded sound of the drill. No drill dentistry is gaining more traction thanks to the evidence showing that this method really works. The field of dentistry is evolving and increasingly shifting its focus from the removal of all caries lesions to a more conservative approach that emphasizes preserving tooth structure through preventative measures.


  • Early dental caries does not need to be removed.
  • In patients with minimal risk factors, dental caries typically progresses slowly.
  • Vulnerable tooth structures can be remineralized and dental caries can be reversed when detected early.

Why It's Valuable

As a dental hygienist, you will be a key player in the no drill dentistry approach as the preventive specialist. With this approach, your patient will need your guidance more than ever.