Drill-free caries treatment (Icon)

Tooth decay does not start with a hole but with a white chalky spot: acids from bacteria wash minerals out of the enamel, making it porous and opaque. At this stage the tooth does not need drilling. Icon resin infiltration stops this early decay by filling the enamel pores with a special resin. At UKRMED the procedure is done in the paediatric dentistry department.

Photo: Lijie Chen, Suma Al-Bayatee et al., Wikimedia Commons, CC BY-SA 4.0

What resin infiltration is

Icon is an infiltration method: a liquid resin penetrates the porous, demineralised enamel and, once hardened, seals the routes acids use to move deeper into the tooth. Decay stops and the tooth surface stays intact. No drill, no anaesthetic and no filling, so even young children usually stay calm.

When it is suitable

• white or yellowish chalky spots on the enamel without a cavity;
• early decay found on the contact surface between teeth;
• white spots left after braces around where the brackets were;
• a child who fears the drill while the decay is still superficial.

It is not suitable once a cavity has formed or decay has reached the dentine (the layer beneath the enamel): then standard decay treatment with a filling is needed.

How effective it is

A systematic review of clinical trials found that resin infiltration stops the progression of early decay on contact surfaces of baby and permanent teeth better than preventive measures alone. White spots also become less visible after infiltration, because the resin changes how the enamel reflects light.

How Icon treatment works

1. Examination. The dentist assesses the spots and, if needed, takes a targeted X-ray (an X-ray of one or two teeth) to make sure the decay has not gone deeper.
2. Isolation and cleaning. The tooth is kept dry and cleaned.
3. Etching. A gel is applied to open the enamel pores.
4. Drying. Moisture is removed from the pores.
5. Infiltration. The resin is applied, penetrates and is hardened with a light.
6. Polishing.

The price depends on the number of teeth: there is a rate for up to 10 teeth and for more than 10.

After the procedure

Infiltration stops existing decay but does not prevent new decay. To keep the result:

• brush twice a day with fluoride toothpaste;
• limit sweets between meals;
• come for a check-up and professional cleaning every 6 months.

If white spots appeared while wearing braces, discuss cleaning around the brackets with your orthodontist so new spots do not form.

Icon treatment prices

Sources

1. Chatzimarkou S., Koletsi D., Kavvadia K. The effect of resin infiltration on proximal caries lesions in primary and permanent teeth: a systematic review and meta-analysis of clinical trials. J Dent, 2018. https://doi.org/10.1016/j.jdent.2018.08.004
2. American Dental Association (MouthHealthy). Fluoride. https://www.mouthhealthy.org/all-topics-a-z/fluoride