Policy Statement on Minimally Invasive Dentistry (MID)

 

Purpose:

This policy outlines the principles of Minimally Invasive Dentistry (MID) and the commitment of Washington State Oral Health Coalition (WSOHC) to support and promote MID as a standard of care in dental practice, education, and research.

Policy:

WSOHC supports MID as a patient-centered and evidence-based approach that emphasizes the preservation of healthy tooth structure through prevention, early detection, and minimally invasive treatment methods. This approach aims to improve oral health outcomes while maximizing patient comfort and long-term function.

Background:

Poor oral health impacts people of all ages and can lead to pain, infections, and broader health issues if untreated. Dental caries remain the most common chronic disease in U.S. children, affecting nearly 46% of children in the country, despite being largely preventable. The Centers for Disease Control and Prevention’s 2016 study revealed that over 90% of U.S. adults have experienced cavities, with 1 in 4 adults currently having untreated decay. The costs of traditional treatment (restorations/fillings, crowns) can deepen health and social inequities, with the lifetime expense of a single cavity averaging $6,160.  Supporting the use of MID can help mitigate these challenges and provide a more cost-effective, accessible solution that empowers all people to prioritize their oral health and avoid costly procedures.

Principles of Minimally Invasive Dentistry:

1. Risk Assessment and Prevention:
   Individualize care based on caries risk assessments and implement preventive measures such as fluoride therapy, sealants, dietary counseling, and maintenance of oral hygiene.
2. Early Detection and Diagnosis:
   Utilize diagnostic tools to identify disease at the earliest stages.
3. Remineralization:
   Prioritize non-invasive treatment strategies, including remineralization of early carious lesions with therapeutic agents, such as Silver Diamine Fluoride, before resorting to traditional treatment (e.g. restorations, or other surgical interventions).
4. Minimally Invasive Operative Techniques:
   When traditional treatment (e.g. restorations) is necessary, use conservative techniques that remove the least amount of tooth structure, such as but not limited to Interim Therapeutic restorations.
5. Ongoing Monitoring and Maintenance:
   Monitor patients regularly to update risk, assess lesion progression and the effectiveness of preventive measures, adapting care plans as needed.

Responsibilities:

1. Dental Professionals: Must be trained in MID techniques and committed to applying them in clinical practice where appropriate.
2. Educators: Should integrate MID principles into curricula to ensure new professionals are proficient in prevention-first approaches.
3. Administrators: Should support the implementation of MID through access to appropriate tools, materials, and continuing education.

Review and Evaluation:

This policy will be reviewed as new evidence becomes available, to ensure alignment with current best practices and technological advancements.

Adoption:

This policy is effective as of 11.03.02025 and has been approved by WSOHC