Minimally Invasive Dentistry

What is the holistic oral healthcare team approach?

A holistic, prevention-focused approach to maintaining long-term oral health through patient-centred care plans and management of patient expectations

What are the three main stages of oral healthcare management?

Stage 1: Identification. Stage 2: Prevention. Stage 3: Restore.

What is the purpose of Stage 1: Identification?

To assess the patient's oral health, identify risk factors, determine risk status and establish an appropriate recall period

What is important during the identification stage?

Thorough and methodical consultations, active listening, assessing risk status and determining the appropriate recall period

Why is active listening important during consultations?

It helps identify the patient's concerns, symptoms, expectations and priorities

What should be assessed during a new patient consultation?

Patient complaint, medical history, social history, dental history, diet, extra oral assessment, intraoral assessment and bitewing radiographs where indicated

What should be investigated when assessing the patient's complaint?

Symptoms and pain using SOCRATES

What does SOCRATES stand for in pain assessment?

Site, Onset, Character, Radiation, Associations, Time course, Exacerbating/relieving factors, Severity

What should be included in the medical history?

Medications, medical conditions and xerostomia

Why identify medications that cause xerostomia?

Reduced saliva increases caries risk

What should be considered when taking a social history?

Socioeconomic status, education and oral health priorities

What should be included in the dental history?

Attendance, dental anxiety, oral hygiene and fluoride exposure

What dietary factors should be assessed?

Sugar and acid intake, snacking frequency and timing

What is assessed during an extraoral examination?

The face, head, neck and lymph nodes for abnormalities

What should be assessed during an intraoral examination?

Plaque, appliances, demineralisation, restorations and visible caries

Why may bitewing radiographs be taken?

To detect caries between teeth

What does a comprehensive new patient consultation help establish?

Oral health status, caries risk, tooth surface loss, periodontal status and oral cancer concerns

What are the three caries risk categories?

High, moderate and low

When should caries risk assessment be reviewed?

At every appointment

What determines the patient's recall period?

Individual oral health needs and risk status

What is the purpose of Stage 2: Prevention?

Prevent disease and arrest or reverse early lesions

What are the main components of preventive oral healthcare?

Dietary advice, oral hygiene instruction, fluoride and GP liaison where appropriate

Why is dietary advice important in caries prevention?

Reducing sugar frequency limits acid attacks and caries risk

What is the purpose of oral hygiene instruction?

To improve plaque removal and maintain oral health

How does fluoride help prevent caries?

It promotes remineralisation and reduces demineralisation

Why might the dental team liaise with a patient's GP?

To address medication-related dry mouth, gastric reflux or other relevant medical issues

What two main factors contribute to dental caries?

Plaque biofilm and fermentable carbohydrates

How does dental caries develop?

Bacterial acids cause enamel demineralisation, leading to carious lesions

What is demineralisation?

 Loss of minerals from tooth structure due to acid attack

What is remineralisation?

Replacement of minerals in demineralised tooth structure

What factors help promote remineralisation?

Saliva, fluoride, dietary modification and plaque removal

How can early enamel caries be managed without operative treatment?

Control plaque, modify diet and improve fluoride exposure

What is the purpose of Stage 3: Restore?

Treat lesions requiring restoration while preserving healthy tooth tissue

What is the main principle of restorative caries management?

Preserve as much sound, repairable tooth tissue as possible

Why repair failing restorations rather than replace them?

To preserve tooth tissue and avoid unnecessary removal

When might operative intervention be necessary for caries?

If the lesion is uncleanable, pain or pulp protection is needed, function or appearance requires restoration, plaque control is impaired, or prevention has failed in a high-risk patient

Why restore a carious lesion the patient cannot clean effectively?

To create a cleansable surface and improve plaque control.

Why might operative treatment be needed to protect the pulp?

To prevent further pulpal damage and manage deep or symptomatic lesions

What are the aims of restoring a tooth?

Restore form, function and aesthetics while protecting remaining tooth tissue

What is the principle of operative caries management?

Remove unrepairable diseased tissue while preserving sound and repairable tissue

Does all carious dentine always need to be removed?

No. Some dentine near the pulp may be retained in selected deep lesions if an adequate seal is achieved

Why may caries be left near the pulp during treatment?

To reduce the risk of pulp exposure and damage

Why is an adequate seal important in a restoration?

 It limits bacterial access to nutrients and helps prevent lesion progression

What are the desired properties or functions of a restorative material?

Seal out bacteria, provide antibacterial or remineralising effects where applicable, restore form and function, and support remaining tooth tissue

How can restorative materials help control caries?

By sealing the lesion and limiting bacterial access to nutrients

How can a restoration support the remaining tooth structure?

By restoring function and helping protect weakened tooth tissue

What is the purpose of a review consultation?

Monitor caries, reassess oral health, reinforce prevention and review recall intervals

What preventive measures may be repeated during a review consultation?

Oral hygiene and dietary advice, plus fluoride varnish where indicated

What is assessed when monitoring caries incidence?

New lesions and changes in existing lesions

How is the patient's recall interval determined after treatment?

By individual caries risk and oral health needs

Why is patient education important in oral healthcare?

It improves understanding, decision-making and preventive behaviour.

Why is patient motivation important?

It encourages good oral hygiene, healthy dietary habits and regular attendance

Why emphasise long-term maintenance and regular review?

To maintain oral health, prevent disease and detect problems early

Why should discussions with patients be documented carefully?

To record advice, decisions, risk assessments and agreed care plans

What is the overall aim of holistic oral healthcare management?

Maintain long-term oral health through prevention, risk assessment, conservative treatment and regular review