Australian researchers found a novel way to stop and prevent tooth decay without the dreaded "drill and fill" technique. A seven-year study showed preventive dental care can reduce necessity for dental fillings for up to 50 percent.

Lead author Associate Professor Wendell Evans from the University of Sydney said fillings are unnecessary because many dental decay cases do not require them.

The findings show a preventive dental scheme have more benefits compared to the current technique. The existing "drill and fill" approach removes early decay to prevent cavity outbreak. Upon removal, the tooth is restored using a filling material. The current practice supports the belief that tooth decay is progressive.

"A tooth should be only be drilled and filled where an actual hole-in-the-tooth (cavity) is already evident," said Evans.

Australian researchers noted that 50 years of dental study proved tooth decay cases are not always progressive. They also develop slower - it can take up to eight years for the decay to progress from the enamel to the dentine. During this time, detection and preventive treatment can be done before becoming a cavity that needs a filling.

Evans and team created a series of protocols aimed to assess tooth decay risk, dental X-ray interpretation and pre-cavity decay treatment. They called it the Caries Management System (CMS), a "no-drill" dental technique that has the following features:

More attention will be given when brushing teeth at home. This could include improved tooth brushing skills.

Concentrated fluoride varnish can be applied to early decay sites.

Reduction in sugary beverages and snacks between meals.

Monitoring of specific dental risks.

The CMS technique pioneered in a test among patients with high tooth decay risk at Westmead Hospital. The first test was successful showing that early tooth decay can be halted and reversed without the need for drilling and filling.

General practice dentists in the Australian Capital Territory and New South Wales tested the CMS treatment next. The Monitor Practice Program concluded that decay risk among CMS patients reduced dramatically after seven years. Their need for tooth fillings also reduced by 30 to 50 percent. 

The findings were published in the Community Dentistry and Oral Epidemiology journal on Dec. 7.