Air Abrasion - Drill-Free Dentistry : Think of an air abrasion system as a mini-sandblaster. Instead of turning on a whirring drill, a dentist gives you a pair of goggles and then directs a thin, high-speed stream of air-blown microscopic particles that gently remove decay from your tooth.

Advantage: There's no heat, no vibration, and many times it's all done without numbing your mouth. You'll feel some coolness but it won't hurt. A suction hose removes the gritty particles, which are made from aluminum oxide, a tasteless substance commonly found in toothpaste. It's harmless if accidentally swallowed, although your dentist may place a thin rubber sheet (called a rubber dam) in your mouth to keep you from breathing the particles.

An air abrasion system works best on small cavities that will be filled with non-metallic materials. It's generally used to repair early tooth decay before it spreads. Because this system can be precisely directed, there's less tooth structure lost in preparing for a filling. And unlike regular dental drills, air abrasion systems won't produce tiny fractures in tooth structure. A more recent application of air abrasion is in the relatively new field of MicroDentistry. Thanks to the successful introduction of fluoride into water supplies and toothpastes, tooth surfaces have become more resistant to decay. But decay is still around. Only now it's concentrated in tiny, hidden parts of the teeth, where it can easily be missed until it has broken into the softer inner portion of the tooth (dentin or pulp).

Because it can precisely remove very tiny layers of tooth structure, air abrasion is a major part of MicroDentistry techniques. Special dyes locate tiny pockets of decay, air abrasion gently opens and cleans out the decay, and then the tooth is bonded in place with one of the new, white filling materials or a tooth-colored sealant.

Disadvantages: Air abrasion doesn't work for amalgam (silver) fillings, and the aluminum oxide powder can be messy. Because it uses a high-pressure air stream, there's a minor danger of injecting air into the cheeks or gums. And since an air abrasion system can be costly, only about ten percent of US dentists have air abrasion systems in their offices.