In Bavaria there's a thoughtful dentist who wants nothing more than to protect his patients from the discomfort of the drill. Rather than simply administer anesthetics, he minimizes drilling in the first place. As a result, patients come from miles around to be able to lean back and relax, without any anxiety, in his dental chair.

Straight out of dental school in 1995, Dr. Helmut Kassak opened a brand-new private practice in the small town of Westendorf, Germany (population 1,300). With patient comfort paramount in his mind, he was determined to build a model "practice of the future". From the start, tissue-friendly treatment options and the conscientious application of modern technology and science have been important components in his day-to-day practice of dentistry. Using digital X-ray equipment and a sophisticated computer system, he completely computerized the administration of patient records and treatment follow-up from the very beginning.
"I have always done my best to work without a drill," Dr. Kassak states simply, "and I have always been interested in new methods of treatment."
He wants all his patients, especially the younger ones, to have as positive an experience of dentistry as possible.

The latest techniques
In his first attempt to retire the drill from the battle against caries, Dr. Kassak was quick to enlist innovative air abrasion and laser treatment techniques. But the really big step towards a drill-free dental practice came in 1997 when he introduced the Swedish Carisolv method. Carisolv consists of a two-component gel and some special hand instruments. A drop or two of the gel is applied to the tooth decay. After a short wait, the softened carious tissue can be scraped away without damaging healthy adjoining tooth tissue.
Patients appreciate the method because it causes very little discomfort. In fact, anesthetics are almost never needed. Because the Carisolv instruments are designed to scrape, rather than cut, the dentist can avoid "overkill", leaving all the healthy tissue of the tooth intact.
As a conscientious practitioner, Dr. Kassak doesn't t want to remove anything more than necessary. He says that this has consequences in the long term. "I d like to see my patients keep their own teeth well into their 90s," he explains. To realize this vision, saving every healthy portion of every tooth is important.

Both children and adults
Today, about forty percent of Dr. Kassak s patients are children whose parents have been attracted to the virtually drill-free dental environment of his practice.
"All children are afraid of the anesthetic needle and the drill. The sound of the drill alone can terrify even the bravest youngster," says Dr. Kassak. As far as his child patients are concerned, he says that he only has to use the drill in one case out of ten. He also works very attentively with preventive dentistry measures, teaching his patients how best to care for their teeth.
Dr. Kassak uses Carisolv on all kinds of caries, although the Swedish manufacturer recommends it primarily for the treatment of caries in children, and in cases of deep decay or caries near the gum line. The latter application is especially common among older patients.
Since he began to use Carisolv, Dr. Kassak has used his laser less and less because it is slower and causes more patient discomfort. He does, from time-to-time however, combine Carisolv and air abrasion (which is actually a gentle technique, despite the fact that many people associate it with sand blasting!). In these cases, he uses air abrasion to remove filling material or enamel that may be hiding the carious tissue. Once that s done, he can apply a drop of Carisolv to the decayed tissue and start the gentle scraping.
His modern but unpretentious practice in Westendorf is equipped with three treatment rooms where--together with another dentist and four assistants--he primarily serves the local population. Nevertheless, approximately thirty percent of his patients come from outside the local community, sometimes traveling very long distances (as much as 60-100 km) to avail themselves of the gentle treatment Helmut Kassak has to offer. And when local patients move away from town for one reason or another, they almost always return to him for continued dental care.

The future of dentistry
According to Dr. Kassak, even patients who are usually skeptical about avant-garde treatment methods are always satisfied with the results obtained with Carisolv.
It is not difficult to get patients to try Carisolv either. "You don t have to get involved in tricky dental terminology to explain Carisolv," he claims. Then he adds with a smile, "All you really have to do is ask if the patient would prefer to be treated with an anesthetic syringe and a drill or without them."
More and more professionals point to patient comfort and tissue-friendly treatment options as "fundamentals in modern dentistry". Dr. Helmut Kassak agrees that they will be central issues in the development of dentistry in the future.
"From a clinical point of view, saving tissue and doing as little damage to healthy tissue as possible are decisive factors that make more precise treatment of the injured or diseased tissue possible. This is good for the tooth, good for the patient, and good for the dentist too!"