NEW TOOL USED TO FIGHT DECAY BY DENTISTS

The amount of decay on one of Jessica Kooyer's molars was so small that in the past dentist Dr. Jeffrey D. Patton might have taken a watch-and-wait attitude.

But last week, he used a new air abrasion machine in his office to remove the decay with tiny particles under air pressure (sort of like mini-sandblasting), then used a flowable composite to fill the small hole. The air abrasion technique not only removed a minimal amount of healthy tooth, it did so with little vibration, no loud drilling noises and Kooyer needed no anesthetic.

"It was easy," said Kooyer, an employee at Patton's dental office, after the procedure was completed. She liked not having a numb mouth and the ability to eat right away. "I'll take this any day over having to get a shot," she said.

"Air abrasion allows you to conservatively treat small cavities with no heat, no noise, no vibration and 90 percent of the time you can do it without anesthetic," said Patton, whose office is one of two in Cape Girardeau that have air abrasion machines. The other is the office of pediatric dentists Dr. David Johnson and Dr. Jayne F. Scherrman.

Patton said air abrasion is also fast. Because there is no need to wait for anesthetic to take effect and the cavities are so small, Patton said it takes him about 10 minutes to fill a cavity, about one-third the time it takes when a cavity is large enough to require using a burr, a devise more commonly known to patients as "the drill."

Air abrasion works best on tiny cavities that form in the grooves on the top of teeth. These cavities often don't show up on X-rays, so Patton uses a mini-camera system that takes close-ups of teeth. He said it is important to catch these cavities when they are small because of the changes in the decay process brought on by fluoridation.

Fluoride hardens the outside of the tooth and makes cavities less likely, but decay can still sneak in through grooves or tiny cracks in the teeth, Patton said. A tooth will look healthy on the outside, but the inside could be completely decayed, he said.

Patton has found that finding decay in those grooves with his camera and blasting it with air abrasion before it seeps into the center of the tooth, reduces the need for large fillings and crowns.

Johnson said he and his partner Scherrman use air abrasion for small cavities on tops of teeth and for sealants. Sealants are a coating put over the surface of the tooth to prevent food from packing into grooves, which can lead to decay. Air abrasion is used to clean and prepare the surface of the tooth for the sealant.

Johnson said advantages of air abrasion to his young patients is that it doesn't make noise like a drill and there is no need to give a shot with anesthetic, both things that make children nervous.

The disadvantage is air abrasion is messy, Johnson said. "It blows powder out. We use a rubber damper to keep the powder out of the patient's mouth."

Patton said his air abrasion machine has a powerful vacuum that cuts down on the mess.

Johnson and Patton both emphasized that air abrasion won't replace the need for the drill. Air abrasion isn't good for large cavities. Patton said he usually keeps burrs ready when he uses air abrasion in case the cavity has penetrated into the tooth and is larger than it appeared.

But air abrasion does give these dentists another tool with which to treat patients.

"It costs less than a traditional filling because it takes less time and equipment," Patton said. "I think this is a technology that will be in most dental offices in a few years."