Dr. Pesillo’s letter provides a wonderful counterpoint to my article, and his insights illustrate the necessity of embracing a multifaceted approach when managing early carious lesions. As he correctly points out, early intervention may involve non-invasive preventive procedures, rather than minimally invasive restorative procedures. It is exciting to witness dentistry awakening to the challenge, and we can only hope that the profession will keep an open mind in its quest to codify appropriate therapy as it designs new treatment modalities.
Dr. Pesillo may remember the flurry of correspondence in response to the initial June 2001 JADA article by Dr. James Hamilton and colleagues, "A Clinical Evaluation of Air-Abrasion Treatment of Questionable Carious Lesions: A 12-Month Report," and to the December 2002 JADA article, "Early Treatment of Incipient Carious Lesions: A Two-Year Clinical Evaluation." Letters to the editor regarding these articles appeared in November 2001, February 2002 and April 2003 issues of JADA.
This healthy exchange of ideas in a forum provided by JADA is laudable. Hopefully, airing our thoughts on this subject has jarred many of us away from our complacency, started us thinking about innovative treatment alternatives for our patients, prompted us to update our office facilities and encouraged us to move in new directions. When, in fact, the removal of tooth structure becomes necessary to eliminate pathology and restore oral health, let’s hope that we are equipped to deal with that scenario with 21st-century armamentaria that allow us to do our patients no harm in the process.
