Resin Sealing of Teeth may Replace Painful Drilling – University of Copenhagen

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02 February 2017

Resin Sealing of Teeth may Replace Painful Drilling

DENTIST

At least 50,000 cavities which every year are repaired by fillings in children and young people may instead be treated by resin sealing. This is the conclusion of a research project from the School of Dentistry at the University of Copenhagen. It is healthier for the teeth and may save dental patients both worries and pain.

Anaesthesia, screeching drills and plastic fillings may in many cases be replaced by pain free resin sealings. At least 50,000 of the caries attacks of chewing surfaces - which are each year drilled away and filled - may instead be treated with a so-called SEAL treatment.

For seven years, a clinical research project from the School of Dentistry at the Faculty of Health and Medical Sciences at the University of Copenhagen has followed more than 500 children and young people at the municipal dental care in nine municipalities, and now the conclusion is clear: SEAL treatments may postpone fillings and in some cases outright replace them.

The two researchers behind the project, associate professor Vibeke Qvist and PhD Azam Bakhshandeh explain as follows: "All the children had caries, which their dentists had decided to treat with drilling and fillings. After a lottery draw, two thirds of them received a SEAL treatment rather than a filling, and seven years after the first treatment, more than half of the SEAL-treated caries attacks had still not been filled.”

The alternative SEAL treatment may be used for sealing of filling-demanding caries (cavities) on the chewing surfaces of permanent teeth, i.e. not baby teeth. The idea for the project came from a former Danish-Norwegian project, led by Vibeke Qvist. Here she noticed that dentists often drill and fill cavities early on even though studies have shown that a dense sealing in many cases will stop the development of caries.

"The sealing protects the tooth surface against further bacterial acid exposure, thereby preventing the cavity from becoming larger", explains Vibeke Qvist, adding: "As long as the destruction of the tooth because of caries is superficial, you will primarily treat the disease by improving oral hygiene, with a fluoride painting or a resin sealing."

Material and execution of a SEAL treatment corresponds to what many patients know from a painting. The novelty of our study is that the researchers have shown that sealings may also be used in case of larger caries attacks, explains Azam Bakhshandeh.

Sealing alleviates the fear of dentists 
The team behind the project emphasises that at the very moment when the dentist starts drilling in a tooth, it is weakened. Therefore, it is clearly preferable if you can settle for a sealing. One filling lasts an average of 12-15 years, and each time it needs to be exchanged, the dentist will drill a little more, and the tooth is further weakened. Also the tooth's owner will in many cases be grateful to escape the drilling, adds Azam Bakhshandeh. Four out of ten Danish adults are actually afraid of seeing the dentist.

"The more afraid you are, the less often you will see the dentist. Most often it is anaesthesia and drilling which cause the most anxiety, so this alternative treatment is received with open arms by those who are afraid of going to the dentist. However, a sealing does not last as long as a filling so a SEAL treatment requires regular check-ups in order that the dentist or hygienist may determine whether the sealing is still tight and that the caries attack underneath the sealing has not advanced. Perhaps you will also need another treatment. Therefore, a SEAL treatment is not cheaper than a filling", says Vibeke Qvist.

In a previous study, Azam Bakhshandeh has shown that SEAL treatment is also suitable for adult patients. Now that there is evidence for the efficiency and longevity of the treatments for both children and adults, researchers and the Dental Association hope that the SEAL treatment will be included in the collective health insurance agreement in order that patients may receive reimbursement for treatments in private practices.

The next step for the team behind the project is to spread awareness of their findings in order that the treatment method may be implemented at all dental clinics throughout the country, both municipal and private. Similarly, patients - children and adults – should be informed that the treatment method exists so they may have a say so as to whether they want a SEAL treatment or a filling. In addition, the team has started a clinical project to increase the current knowledge about the factors that affect the durability of sealings/SEAL treatments.

The results from the project “Sealing Occlusal Dentin Caries in Permanent Molars: 7-Year Results of a Randomized Controlled Trial” has been publicised in JDR Clinical and Translational Research.

Contact:
Associate professor emeritus, PhD, Dr. Odont. Vibeke Qvist, E-mail: viq@sund.ku.dk, telephone: +45 35 32 68 12
Assistant professor, PhD Azam Bakhshandeh, E-mail: azamba@sund.ku.dk, telephone: +45 35 32 68 11