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Prophylactic Odontotomy

Sectioned tooth shows fissure smaller than single toothbrush bristle, making it difficult to clean.

Figure 1: Pits and fissures in teeth may be too deep and narrow to allow access for even one toothbrush bristle, as illustrated by this cross section of a tooth. A prophylactic odontotomy may be a solution.

Prophylactic odontotomy is a procedure in which the deep pits and fissures in a tooth are eliminated by widening the grooves with a cone shaped dental bur (shaping tip). After this procedure is completed, the tooth will trap less bacteria-laden plaque, and what does collect can be easily removed with a toothbrush.

If the pits or fissures in the teeth cannot be completely cleaned with a toothbrush, intervention of some type is suggested. Three methods of treating deep pits and fissures include dental sealants, prophylactic odontotomy, and use of topical fluoride—or appropriate combinations as recommended by your dentist.

A cavity forms in a pit or fissure.

Figure 2: Left untreated, a cavity can form in the crack.

Prophylactic odontotomy is often an excellent option for eliminating the problem of bacterial plaque accumulation in the deep pit and fissure anatomy in teeth. If the grooves can be eliminated without perforating the enamel shell, no sealant may need to be placed. The dentist will still be able to check the teeth with an explorer and a laser caries detection device at checkups, which is not always possible with a sealant in the tooth.

The procedure can be performed quickly and painlessly, without special measures for moisture control. In the United States, they are required to be done by dentists, because only a dentist is allowed to remove tooth structure.

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Author: Thomas J. Greany, D.D.S. / Editor: Ken Lambrecht

This page was last updated on December 17, 2018.

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