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Minimally Invasive Dentistry

It is said that “we do better, when we know better”. Nowhere is this adage more true than in the “healing arts”. Often dentistry is not looked at as a healing art. The truth is dental and oro-facial tissues are some of the most complex tissues in the human body. Therefore, research around “healing” has been slow to bear fruit. However, many of us in the dental community have embraced non-invasive dentistry. We also call it MINIMALLY INVASIVE DENTISTRY or REGENERATIVE DENTISTRY. Here are some of our offerings in this arena, in an effort to better care for our patients. As the science of regenerative dentistry advances, we at Enso promise to do better as we know better in dentistry and bring the gentlest treatment options to our patients, as they become available.

Can I avoid a silver-mercury filling?

Historically, all large cavities on the back teeth demanded that they were filled with the stong silver mercury fillings that could withstand the strong chewing forces. Composites were just not strong enough and were good for the front teeth only. Unfortunately silver mercury fillings may be strong but have a set of physical properties so vastly different than the tooth that eventually the tooth suffers and is very prone to fractures and cracks. The newer stronger composites are amazing in that they bond the walls of the tooth from inside and reduce the chance of cracks and fractures. The system we have at Enso for posterior composites goes a step further and provides us the ability to place a composite filling so well crafted, it is filled 80% with porcelain! We are in awe too! This is truly the stuff we, in the dental field, dreamed of years ago. The future is here. Enso is one of the few dental offices that has invested in this technology. So committed are we to this new technology that we have it fitted in each operatory in our office! So what is this new technology? Well, imagine if you need a filling on a molar. Would you want the cavity filled with something that is mostly resin composite or strong porcelain?

Historically, the only way to get your teeth filled with strong porcelain was to get an inlay or an onlay. Porcelain Inlays and Onlays are a great treatment choice when the cavity is big. But, they might be too expensive and unnecessary for repairing smaller cavities. For these kinds of medium to small cavities, we have a great option available now called the SONICFILL! This technology is brought to us after years and years of research and development at Kerr and Kavo. It comprises of an air-driven handpiece that generates sonic vibrations that liquifies the hard composite that is 80% filled with porcelain fillers. The operator is thus able to tightly pack the cavity with this very strong mix and actually bond it to the tooth structure. A special “curing light” polymerizes this restoration immediately. Patients are free to chew on the filled tooth right away. No restrictions and no second visit needed!! And the best part? It costs the same as a regular composite filling!

Can I avoid a Root Canal?

The best way to avoid root canals and other invasive treatments is to get regular dental check -ups, Of course and focus on preventive dentistry and great home care. However, in case of very deep cavities that threaten the nerve/pulp of the tooth, we now have a great option! A biomimetic material called Theracal that helps “heal” the tooth from inside. Of course, this therapy cannot be used on teeth that are irreversibly inflamed or already necrosed. But, it is a great treatment for teeth with deep decay and even teeth with reversible inflammation! TheraCal LC is a light-cured, resin-modified calcium silicate filled liner designed for use in direct and indirect pulp capping and as a protective liner designed to be placed under other base materials. TheraCal LC performs as a barrier and protectant of the dental pulpal (the nerve canal of the tooth and root) complex, helping to stimulate secondary dentinal bridge formation in an effort to avoid root canal. TheraCal LC’s precise placement allows it’s use in all deep cavity preparations. Its proprietary formulation allows for a command set with a light curing unit while maintaining ease of placement due to thixotropic properties. The proprietary hydrophilic resin formulation creates a stable and durable liner.

  • Calcium release stimulates hydroxyapatite and secondary dentin bridge formation
  • Alkaline pH promotes healing of the tooth from inside.
  • Significant calcium release leads to protective seal
  • Protects and insulates the pulp (the nerve of the tooth)

There are several studies showing that Theracal may be far superior to other agents used for “tooth healing”. Here is one recent study…

Int Endod J. 2012 Jun;45(6):571-9. doi: 10.1111/j.1365-2591.2012.02013.x. Epub 2012 Mar 31.

Chemical-physical properties of TheraCal, a novel light-curable MTA-like material for pulp capping. Gandolfi MG, Siboni F, Prati C.


AIM: To evaluate the chemical-physical properties of TheraCal, a new light-curable pulp-capping material composed of resin and calcium silicate (Portland cement), compared with reference pulp-capping materials (ProRoot MTA and Dycal).

CONCLUSIONS: TheraCal displayed higher calcium-releasing ability and lower solubility than either ProRoot MTA or Dycal. The capability of TheraCal to be cured to a depth of 1.7mm may avoid the risk of untimely dissolution. These properties offer major advantages in direct pulp-capping treatments.

Can I avoid a Deep Cleaning?

Deep cleaning, also known as Scaling and root planing, is really the first line of treatment for periodontal/gum infections. It is a tried and true remedy but unfotunately does not provide all the answers patients are looking for. Perio protect is a non invasive therapeutic option that may go a long way towards avoiding re-SRPs and deterioration of gum disease.The Perio Protect Method® is an effective, sensible approach to treat bacteria that cause gum disease. At the heart of the Method is the adjunctive Perio Tray® delivery of medication. The basic idea is to get medication under the gums and into the pockets where bacteria grow and keep it there long enough for the medication to work, all in a comfortable, non-invasive way. Not a simple task. That’s why the Perio Tray is such an important advancement.

The Perio Tray is easy to use. You put the medication into the trays, wear the trays at home as instructed by your dentist and, well, that’s it, until you return to the dentist for a recall visit. It’s comfortable, it works well, and it’s convenient. The Perio Protect Method’s combination of Perio Tray delivery with thorough cleanings from a dental office is the least invasive approach available, and research shows better results than cleaning alone.

Do you have missing teeth?

Missing teeth can ruin your smile even if they are not right in the front. Teeth that have been lost due to decay or gum disease lead to spaces that create a less than optimum bite/occlusion for you. Eventually this leads periodontal and other occlusal stress related problems with adjacent teeth.

We have many options to restore your missing teeth including dental implants, bridges, minimally invasive Maryland bridges for missing front teeth and esthetic partial dentures.

Your best option can be determined after an exam and x-rays to see your bone level.

Perio Trays are custom fit for individual use. They have a special seal and extension system that correspond to the conditions of the gums around each tooth. The seals and extensions help direct and maintain medication under the gums to the site of the infected wounds. For most people, treatment time amounts to minutes each day. As healing occurs and conditions improve, dentists will modify your frequency and duration of usage, gradually decreasing patient usage until the infection is under control and the disease is well managed. You can then follow a homecare maintenance schedule to keep the bacteria at bay.

For research articles and case studies on the Perio Tray delivery of medication, click here.

Our Office is proud to be Perio Protect Certified. Contact us and set an appointment to see if the Perio Protect Method is right for you.

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