New 'air-abrasive' dentistry
Woodinville dentist Michael Koczarski is among approximately 2500 dentists using a new technique called Air-Abrasive Micro-Dentistry that in most cases requires no drilling, anesthesia, or pain to fill cavities.
"It's a process still uncommon in dentistry and one that draws some skepticism", he said.
By using a "mini-sand-blaster," Koczarski can cut teeth less than fourteen-thousandths of a millimeter (the equivalent of splitting human hairs). Then, using a composite resin, he fills the cavity and sets it with a laser, leaving the rest of the tooth structure intact.
"After years of searching for a better preventative surgical method," said Koczarski, "I believe I have found it with the air-abrasive approach. I didn't enjoy watching my patients suffer through the pain of a filling, and knew that by drilling, a tooth was weakened and susceptible to cracking--leading to caps, crowns, and bridges later on."
That belief was shared by J. Tim Rainey, the man who considers himself the founder of modern micro-dentistry and is co-founder of the Texas Institute for Advanced Dental Studies.
"Once you touch a tooth with a high speed drill, the damage is done. That's where the crowns and the root canals of dentistry came from," according to Rainey. Because silver contracts and expands at lower temperatures than teeth, the fillings would lead to even more damage.
The concept of air-abrasive dentistry is not new. The original machine was invented in 1943, right before the high speed drill. Unfortunately, the holes created were too small to accommodate a silver filling. Considering, as well, the high cost of the air-abrasive machine, the high-speed drill became the norm.
Rainey became interested in the air-abrasive concept in the 1970s, and by the mid-1980s had developed the procedure with the new filling material--a combination of glass resins that more closely match the material in human teeth.
The cost of the machine is still prohibitive. Koczarski estimates that acquiring the air-abrasive unit, laser, and magnification tools set him back more than $31,000. But it also makes treating cavities a quick process. On one patient, he filled nine cavities during the appointment hour.
"This is the wave of the future," Koczarski said. "This is the way it is going to be."
Though air-abrasion may sound like it means the death of the drill, there are limitations. Once a silver filling has been used, micro-dentistry can't be used. And in some cases where there is deep decay, the drill still will be required. Koczarski sees air-abrasive micro-dentistry as a preventive measure to protect teeth from further decay by catching it early, before it even shows up on an X-ray.