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J Arch Mil Med. 2014 December; 2(4): e25229.
DOI: 10.5812/jamm.25229
Published online 2014 November 15.
Minimal Intervention Dentistry in the Society of Armed Forces
Mohsen Aminsobhani
1Department of Endodontics, AJA University of Medical Sciences, Tehran, IR Iran
*Corresponding author: Mohsen Aminsobhani, Department of Endodontics, AJA University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188950567, Fax: +98-2166431744, E-mail:
Received: November 9, 2014; Accepted: November 9, 2014
Keywords:Army; Dentistry; Military Personnel; Minimal Intervention; Minimally Invasive
By early 1990, researchers had changed the management of dental caries from the traditional surgical approach to a biological or medical approach. In modern
operative dentistry, caries is managed as an infectious disease, and the focus is on maximum preservation of tooth
structures (1). Minimal intervention dentistry (MID) is a
new and important concept that should be considered
for military personnel.
The philosophy of MID previously called minimally
invasive dentistry was referred to prepare the smaller
and more conservative cavities. The goal of MID is to
keep teeth healthy and functional for entire life. The oral
healthcare professionals must consider both individualized and population-based strategies for improving oral
health. MID scopes are treatment objectives using the
least invasive surgical approach with the minimal elimination of healthy tissues. However, today, the concept is
much broader and includes treatment related to risk assessment of patients, the early discovery of oral diseases,
directed preventively orientated policies and limited surgical intervention proper for the level of disease.
This concept, therefore, is not only limited to the management of dental caries but is also appropriate for other
areas of oral health such as periodontology, oral rehabilitation and oral surgery and also endodontics. Scaling and
root planning instead of severe periodontal surgeries,
microsurgical endodontic techniques, tunneling technique for the removal of pulp horns during access cavity
preparation in anterior teeth are some examples of MID.
MID principles do not consider the dental caries as only
an infectious disease but instead a behavioral disease
with a bacterial component. For practical incorporation
of these principles into routine dental practice, the profession and the patients will need education in the new
model. In many places, in our treatment methods, we
still think about "extension for prevention" (2).
The fluoridation of water, using new technologies like
laser beam for caries removal, laser caries detection systems, caries indicator dyes, adhesive materials and adhe-
sive systems, ozone gas, resin infiltration combined with
fluoride varnish application, pit and fissure sealants and
fluoride varnish application are all necessary for successful MID. But controlling the behaviors, i.e. intake and frequency of fermentable sugars and carbohydrates, to not
more than five times daily and removing dental plaque
or dental biofilm from all tooth surfaces by brushing and
using an effective fluoridated toothpaste twice daily can
increase the chance for successful MID (1, 2).
Nutrition control, in terms of the consumption of fermentable sugars; using xylitol, sorbitol and the sugarfree products; incorporating casein phosphopeptideamorphous calcium phosphate agents in chewing gum
or in prophylactic pastes with or without fluoride are still
important factors in managing caries development (2).
An overview of factors affecting the health shows that,
most problems are related to the way people live and
their origin is behavioral. All of these behaviors are obtained in the life environment and ministry and then are
reinforced. Unfortunately, oral health is usually neglected more than the other parts of the public health.
In the armed forces with convenient access to dental
insurance services, some factors such as low levels of
knowledge and attitudes about the adverse effects of oral
diseases on body health and its risk factors; low public
perception for regular dental care and referrals to dentists and on the other hand, employment status (presence
in remote areas); and also social and economic issues; are
considered the serious obstacles to the improvement of
oral health in this population.
With scientific regulation and reasonable planning,
dramatic success can be achieved in the prevention of
oral diseases with spending far less cost. In particular,
with the proper implementation of preventive health
care programs, the significant results can be expected
because the personnel of our armed forces are fully accessible.
Undoubtedly, the first step is to collect information
about health and health care systems in this field. In any
Copyright © 2014, AJA University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages,
provided the original work is properly cited.
Aminsobhani M
organization, this information is essential as a key tool.
These can determine the current status and our needs.
The next major step is to influence the attitudes and beliefs of the aimed society in order to solve the problems of
their own oral health.
For the successful MID in the army, the army staff, duty
military personnel and their families should be taught
how to brush, floss and use mouthwashes and fluoride
rinse. The etiology of dental caries, and also the worth of
prevention through nutritional and oral hygiene measures should be explained to that population. Therefore,
we should primarily pay attention to the control of the
caries, dental plaque and calculus formation, and reduction in carbohydrate intake of the army population.
These need to organize dentists and oral hygienists for
teaching and screening the population about their oral
An individual at no time is free from dental caries or oral
disease. The "whole population" approach is suitable for
the prevention of oral and dental diseases and applying
it is the only way to decrease the burden of these diseases
and the cost of oral care (2). For this purpose, the medical
services health insurance of the armed forces can do this
better than other organizations.
At the end, if MID is to make an effect in supporting the
purpose of ‘teeth for life’ for military staff and their families, it must be included in the dental curriculum. The concepts and objectives of MID should be taught to the dental
students of the AJA University of Medical Sciences. Also, the
researchers must target toward the MID in the army.
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J Arch Mil Med. 2014;2(4):e25229
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