St. Lawrence Dentistry offers a minimally invasive treatment option for cosmetic defects and minor enamel cavities. This includes teeth with ‘white spots’, or have a cloudy appearance.
ICON is made by DMG and is the first ever white spot treatment product which acts by a process called ‘infiltration’. This is an ideal treatment method as there is no drilling on the tooth in many cases. Infiltration offers a totally new treatment method for white spots on teeth. It can treat a white spot which has progressed well into the dentin layer of the tooth. White spot lesions are not only a disturbing cosmetic problem but are actually sometimes a visible stage of an early cavity. If they are cavity related it is important that they are treated at this early ‘white spot’ stage so they won’t progress.
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White spot lesions are created by a cyclical imbalance between demineralization and remineralization, resulting from an acidic environment created by bacteria. Pathogenic bacteria breach the outer tooth layer and organic acids produced by the bacteria leach out calcium and phosphate ions which are not replaced naturally remineralization process. This creates an imbalance on how light is reflected from teeth. Different aspects of the tooth surface will reflect, refract, and absorb different wavelengths of light at different degrees. A disturbance in the enamel matrix results in altered appearance. The outer layer of the tooth’s dissolution begins with subsurface demineralization creating pores between the enamel rods (a type of tooth structure). Mineral loss creates an optical phenomenon or chalky white enamel. Surface roughness and loss of surface shine result in an altered refractive index and increased visual opacity. These white spots or alterations in tooth color can result from trauma, infection, lack of minerals, Fluorosis, Fever, Premature birth, Illness during gestation, or it can have a genetic origin. In addition, white spots can be caused by plaque, orthodontic brackets, and a heightened acidity level.
There are 2 classes of white spot lesions and Dr. Hawryluk will diagnose what your individual situation is. The first is ‘Active Lesions’. These may improve on their own with adequate oral hygiene. They are characterized by a dull pitted and irregular surface. They have a favorable prognosis to regain their translucency due to porosity which readily allows incorporation of calcium and phosphate. The second is ‘Arrested Lesions’ and are unlikely to reverse on their own. They are characterized by a flat and shiny white or sometimes brown surface. They have a lack of porosity and formation of a remineralized layer on the outer part of the tooth. In both these cases, the new ICON technology reinforces demineralization areas by capillary action uptake of highly fluid resin which seals enamel porosities and creates a diffusion barrier preventing further cavitation or breakdown of the tooth. Infiltration of resin impregnates the voids left by decalcification. It has the same refractive index of enamel so it restores the optical nature of the treated tooth surface to its natural aesthetics without removing the enamel.
Depending on the size of the lesion, Dr. Hawryluk may suggest bleaching first as this may reduce the size of the white marks and the entire appearance of the lesion. It is important to understand that the white spots may appear whiter and brighter as the bleaching commences. If you or your child just finished orthodontics we may suggest waiting 3 months after the completion of the orthodontics due to the ability of some of the lesions to regress
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Before treatment, the teeth are thoroughly cleaned and any debris rinsed off. The use of a conditioner ensures the successful removal of the surface zone of any early breakdown which helps facilitate the infiltration process. After the conditioner use, the pore volume of the incipient breakdown will be accessible. Next, the gel is rinsed by water. The remaining water in the porous hard tissue will inhibit the penetration of the infiltrate and must be removed. This is done by rinsing the area with an ethanol solution. Dr. Hawryluk will inspect the area at this step and it will be possible for him to forecast the future aesthetic outcome at this stage. The infiltration process begins by means of specially designed application tips. The specifically developed resin is applied slowly in 2 steps. The first application of the infiltrate is allowed to penetrate deeply for 3 minutes. Excess is removed with a cotton roll and dental floss and the area is light cured. This process is repeated whereby the second application is made for only 1 minute. By successfully filling the area with the infiltrate the area of breakdown is stabilized and sealed and progression arrested.
Below is a link to an excellent video showing the process:
The after procedure instructions are as follows: For at least 24 hours after treatment, refrain from any dark colored foods or beverages that may stain teeth. Soft brushing with a warm salt water rinse along with eating soft foods is recommended. The irritation will resolve within a few days. Please remember to brush in the morning and at night with extra focus on the gum line and floss daily to ensure clean and healthy gums.
The optical presentation of the tooth defect is impressive after the infiltration. The lesions pore volume is now filled with a medium that has a similar light reflection index to healthy enamel so the white spot can no longer readily be detected. Dr. Hawryluk will finish the restored area is with fine polishing aids. Do not worry about the resin changing the color of the tooth, it just mimics the natural color of the tooth.
A further advantage of this innovative treatment is it does not change in any way the anatomical shape of the tooth. ICON combines state of the art dentistry with the patients wish for drill-free treatment in order to protect and preserve healthy tooth structure. A very satisfactory treatment result can be achieved in a single sitting.
If you would like more information about ICON drill free treatment at St. Lawrence Dentistry please give us a callclick here.