The Benefits of Minimally Invasive Dentistry

Story at-a-glance -

  • Early intervention with minimally invasive dentistry can eliminate 80 percent of future dental interventions on the vast majority of patients
  • By identifying hypocalcific areas and using a miniature air abrasion tip to clean out those pits, fissures and grooves, removes the initial decay. The area is then sealed with glass ionomer. The end result is that those teeth tend to not decay in the future
  • Tooth decay is primarily driven by the symbiotic relationship between bacteria and acidity, which creates a pathogenic bioflora in your mouth. If you’re continually lowering the pH in your mouth, you start losing calcium, which is necessary for strong healthy teeth. Calcium deficiency leads to porosity in the teeth, which allows plaque that has turned pathogenic to attack the tooth more thoroughly
  • The three main components of minimally invasive dentistry comprises dietary prevention (creating a healthy bioflora in your mouth and body), dental prophylaxis (baking soda; oil pulling), and minimally invasive restorations, which will help prevent ever needing more invasive procedures like root canals, crowns, bridges and implants

By Dr. Mercola

It's very difficult to achieve high-level physical health if your dental health isn't effectively addressed. I've been involved with alternatives to regular dentistry for quite some time. I think many people fail to appreciate how important dentistry is to our total health.

Most tend to separate these two components, but both need to be considered as working in tandem.

Contrary to conventional dentistry, minimally invasive dentistry, like biological dentistry, is not about "drilling and filling;" creating an endless loop of revisits and retreating the same tooth again and again.

Instead, by using dietary prevention to create a healthy cavity-fighting bioflora in your mouth; dental prophylaxis such as brushing and irrigating with baking soda, and oil pulling; combined with minimally invasive restorations starting as early as possible, you can prevent about 80 percent of future dental problems.

Minimally Invasive Dentistry — A Valuable Aspect of Biological Dentistry

Dr. Tim Rainey is a true pioneer in biological dentistry, and is a big proponent of and leader in what's termed "minimally invasive dentistry."

"Basically, I knew that the way that we were preparing teeth back then was dead wrong; that you couldn't go in and justify destroying massive amounts of tooth structure," Dr. Rainey says. "...We need to be much more conservative."

After dental school, the training and dogma of which he rebelled against, he began investigating alternatives to the standard "drill and fill" dogma. After reading a hallmark article by a Japanese researcher back in 1977, he began to put everything together:

How tooth decay actually occurs, what the tooth looks like on the inside, how the decay looks like, and finally, what could be done to minimize the damage being done to the tooth while trying to restore it.

"It took me about until 1983 to really understand what was really going on within the teeth. I'm talking several years there. I'm talking about dissecting hundreds, if not thousands, of teeth...

I realized two things. Number one, we did not even have a rudimentary understanding of the decay process in the teeth. Number two, everything that we've been taught about tooth structure and anatomy was just dead wrong.

By 1985, I had actually published the article on how to address 80 percent of all decay, which is in the chewing surface of the back teeth. That's where most decay starts. We had a rather crude rudimentary way of going in and treating these teeth," he says.

Minimally Invasive Restorations Can Last a Lifetime

The first patient he used his newly devised procedure on was the daughter of one of his class mates from dental school. The girl received these minimally invasive restorations in 1983 or '84. Today, she is Dr. Rainey's lead hygienist, and those restorations are still there, and those teeth have never decayed or broken down.

This is in stark contrast to what happens with most conventional fillings, especially if the dentist uses amalgam (about half of which is mercury, despite being deceptively referred to as "silver filling"). When you drill into the tooth with a high speed drill, and then stuff amalgam or other incompatible material in there, you can be almost certain that you will need additional work on that tooth down the road as the tooth begins to crack and the tooth structure fails.

"The average is somewhere around 14 to 15 years before the breakdown of the first restoration in the tooth and then somewhere around eight years for the second restoration," Dr. Rainey says.

"Then you're into the tooth has fractured, you start getting decay in between the teeth. That's the root. That will destruct your teeth. Decay starts breaking down the teeth, and then you start getting into crowns and root canals. Here you have a whole series of manmade iatrogenic (dentistry-caused) 'disasters,' which fuels the future generations of dentists. It also fuels 80 percent of what all dental practice is about, that is repairing previous dentistry."

By using early diagnosis and early intervention with minimally invasive dentistry, Dr. Rainey and other dentists trained in his techniques have eliminated 80 percent of future dentistry on the vast majority of their patients who are privileged to grow up in a practice such as theirs. As someone who has struggled with my own dental health, this sounds absolutely extraordinary. That equates to phenomenal savings in terms of money, pain, and emotional anguish, if you happen to be afraid of the dentist chair.

"Remember, there are several other people throughout the world who are now doing this. It has a very profound effect. We're talking about something that the evidence of information has been out there approaching 30 years – three decades. Dental patients found out about it like they did in alternative medicine... They seek me out from all over. We have patients coming in from Canada. We haven't even counted the number of states; I would say something around 30 states," Dr. Rainey says.

"Of course, there are easier and simpler ways to do dentistry! You start these kids off very early. You eliminate the decay... and guess what? They don't have much decay later on. We call it bulletproofing the teeth; where we go in, identify the defective pit, fissures, and grooves in the teeth, and clean those out.

There are several different types of materials that we can use. My preference is for glass ionomer cement... Not only do those chewing surfaces on those teeth never decay, but the interproximal areas are gaining some degree of protection because you're removing the nidus of the infection, which is the bacteria within the teeth that are causing decay. You don't have that bolus of xbowel bioactivity there to lead off into decay."

Understanding Tooth Structure

The tooth is covered with a layer of lipoprotein, laden with calcium phosphate that comes and goes — eating and drinking, especially acidic foodstuffs and beverages, remove it, while saliva puts it back. Beneath that is an extremely hard and dense layer of enamel, which is about 0.2 millimeters, or 200-400 microns thick. Inside of that hard layer, the tooth structure becomes much softer. These parts all form the structural integrity of the tooth.

When you bite down on the tooth, the stress is transferred through the entire tooth down into the root, which deforms slightly. This is part of its natural stress-relieving mechanism. During the formation of the tooth can form little pits, fissures and grooves that may be hypocalcific — a defect that causes the enamel to be softer than normal and susceptible to decay.

"In the ideal world, you do not have decay start down in these pits and fissures, because you have a natural oil-based organic plug that seals that tooth," Dr. Rainey explains. "However, in the real world what happens is as these teeth are finalizing development, you'll get what we call 'hypocalcified enamel.' Now, if you put acid in that area, then you start getting a calcium deficit. That's the beginning of decay in teeth."

He identifies those areas, and using a miniature air abrasion tip that is very precise and focused, cleans out those pits, fissures and grooves. This removes the initial decay. Then he seals it with glass ionomer. The end result is that those teeth tend to not decay in the future.

Why Decay Occurs

Tooth decay is primarily driven by the symbiotic relationship between bacteria and acidity, which creates a pathogenic bioflora in your mouth. If you're continually lowering the pH in your mouth, you start losing calcium, which is necessary for strong healthy teeth. Calcium deficiency leads to porosity in the teeth, which allows plaque that has turned pathogenic to attack the tooth more thoroughly. Once certain types of bacteria are able to penetrate the enamel, they put out enzymes that begin to break down the collagen of the inner structure of the tooth.

"That's where you get cavitation, which is the loss of tooth structure to the point where you have a hole in that tooth," Dr. Rainey explains.

One of the most important things Dr. Rainey instructs his patients to do is to use nothing but baking soda on their teeth at night.

"The pathogenic bacteria must have an acidic environment. Then you have the bacteria – the probiotic bacteria – that live in a neutral environment. You're going to have X number of bacteria regardless of what you do. So, why not promote the non-pathogenic bacteria by neutralizing the acidity with baking soda at night, which has profound effects on the overall oral health of the individual?" Dr. Rainey says.

You can brush with it, use it as a mouth rinse, and even dissolve a little in the water you use in your WaterPik or HydroFloss.

  • To brush: Wet your toothbrush and dip it into the baking soda. Brush as usual. Your teeth should feel smooth when finished
  • To rinse: About a teaspoon in a small glass of water is sufficient. Just swish it around in your mouth and spit out
  • To floss: Dissolve a small amount of baking soda in water and fill your irrigation instrument. Make sure not to let it dry inside your water pik as it will cause buildup and eventually render the tool useless. So, always keep water in your irrigation tool, and instead of storing it standing up, store it upside-down in a glass of baking soda and water, as the baking soda will prevent harmful bacteria from proliferating. Once a week, drain it all out and rinse it thoroughly with water

In the mornings, you could use toothpaste containing calcium and phosphate salts, or even hydroxyapatite, which can help remineralize your teeth.

"Since the Pro-Enamel [toothpaste], I've believed that almost all of the toothpastes out there now have calcium of some form in them. The magic is the calcium phosphate. You want those present, so they can precipitate back into the teeth as amorphous hydroxyapatite... You're rebuilding an amorphous crystal of enamel, because of all the interactions of the enzymes, calcium, phosphate, and everything else that goes on within your mouth.

Where you really mess this up is by getting it too acidic. That's where the baking soda comes in.

We use it in our cancer patients, where they have a real deficit of calcium and phosphate in their saliva – people who have problems. The brand name of it, as a prescription item, is called Caphoso®. You actually get it in a calcium solution, a phosphate salt solution. You mix those together, and then you rinse with them. That's the building block of enamel, and what it takes to remineralize enamel."

Promote Beneficial Oral Bacteria with Fermented Foods

To promote a beneficial oral bioflora he also recommends taking Evora tablets while you're trying to change the bacterial balance in your mouth. Eating fermented foods, such as cultured yoghurt made from raw organic milk (AVOID store-bought yoghurts as they are worthless in terms of probiotics. Most are loaded with sugars and other detrimental ingredients, and all of them are pasteurized), or fermented vegetables, which you can easily and inexpensively make at home.

According to Dr. Rainey, any type of probiotics will naturally help get rid of harmful Strep mutans. This includes Lactobacillus and bacteria that are bioactive in high concentrations of lactic acid.

To Pull or Not to Pull...

Another interesting technique that can help improve your oral health is oil pulling. The technique is thousands of years old, and it's an ancient Ayurvedic Indian tradition. To perform it, you vigorously swish an oil in your mouth, "pulling" it between your teeth for 20-30 minutes. You can use a number of oils for this, but sesame, sunflower or coconut oil are commonly used. Dr. Rainey is also working extensively with ozonated oils.

Oil pulling is thought to remove pathogenic bacteria, improve oral hygiene, and help detoxify your system. Dr. Rainey agrees the technique can be beneficial. A drawback is that it is time consuming. You need to go at it for quite some time in order to get results. It's not like swishing with mouthwash for 30 seconds. Ideally, you'll want to reach close to 30 minutes.

The Three Main Components of Minimally Invasive Dentistry

Contrary to conventional dentistry, minimally invasive dentistry, like biological dentistry, is not about "drilling and filling;" creating an endless loop of revisits and fixing old dental work until there's nothing left to work with. It comprises three main components:

  • Dietary prevention (creating a healthy bioflora in your mouth and body)
  • Dental prophylaxis (baking soda; oil pulling)
  • Minimally invasive restorations

As for dental prophylaxis, the simplest thing is just adding baking soda to your nightly oral hygiene. Ideally, add it to your dental irrigator, and brush with it. You can also use oil pulling in conjunction with this. They're not mutually exclusive. You can combine the two, because it will provide a sort of organic matrix plug, which helps combat dental decay. And ultimately, you want to change the bioflora in your mouth, which is done through your diet. Fermented foods are key. A high-quality probiotic supplement may suffice if you really cannot stand fermented foods. I urge you to at least try some fermented veggies though, as they are, for most people, the most palatable. I think they're delicious!

The next step, (where, ideally, you'd start your kids off) would be to see a dentist trained in minimally invasive dentistry. Kids treated with the NovaMin or baking soda air abrasion process to clean the pits and fissures and then seal them with glass ionomer, receive significant protection against future decay.

How to Find a Biological and Minimally Invasive Dentist

At present, there are a number of dentists trained in Dr. Rainey's techniques. Several of them are in California and Florida. There's also one in Beirut, Lebanon, and in New Zealand. To locate a qualified dentist, you can contact Dr. Rainey's office at, or call 361-526-4695.

If there's no minimally invasive dentistry practice in your area, or within reasonable travel distance, the following links can help you to find a mercury-free, biological dentist. These may not be trained in Dr. Rainey's minimally invasive dentistry technique, but are trained to treat your oral and physical health as a cohesive whole. If you're considering removing amalgam, you also need to make sure it's done by biological dentist that's been properly trained to do it safely, as removing amalgam can lead to severe and acute mercury poisoning: