Almost every pediatric dentist has found themselves in the unfortunate position of being seated across from distraught parents, having to tell them that their child, still a toddler, has early childhood caries. In the past, treatment options for a child under the age of 3 were usually limited to monitoring these carious lesions until the child was older or to treatment under general anesthesia- a wrenching dilemma for parents.

For Dr. Jeanette MacLean, having her own child undergo a surgical procedure at the age of 9 months old dramatically impacted the way she empathized with parents regarding the use of sedation to treat their children’s tooth decay. Years later, she would experience a medical emergency with a special needs child undergoing IV sedation in her office. He recovered; however, it made her question existing protocols and wonder how she could do things differently and better for her patients and their families. This began her journey to minimally invasive dentistry and led to her adopting treatment techniques such as silver diamine fluoride, SMART (silver modified atraumatic restorative treatment), Hall Technique, and resin infiltration. These techniques were not part of formal dental education at the time, which primarily focused on the surgical management of caries. She says, “Shifting to more nonsurgical interventions has enabled me to reduce my use of sedation, increase access to care by increasing the volume of patients I can see, reduce the cost of the care, and improve the efficacy of care.”