A preventive resin restoration is a more definitive treatment for sealing out decay on teeth. These involve cleaning out the groove (fissure) of the tooth rather than just burying it under plastic. The groove can either be cleaned out by an air abrasion device or (as is more commonly used) just a conventional drill. There are advantages and disadvantages to each cleaning device. The air abrasion device has no vibration and very little noise, other than a hiss. However it dose make a fair amount of mess in the mouth from the particles of aluminium oxide which are used to create the abrasive effect.
The drill is quick and clean, but somewhat noisy. Neither technique causes any significant amount of pain at all. Once the groove has been cleaned out a proper assessment can be made as to whether there is any decay underneath the groove. If there is decay there (and decay is found in a surprising number of cases) then the decay is removed with either of the devices mentioned above. Quite often the decay can be completely removed without any pain at all , or without the need for injections. This is particularly true in cases of very shallow decay. If however, the decay gets deeper into the tooth (as happens in about 5% of cases) a local anesthetic may be required to numb the tooth so that the decay can be removed properly without causing undue discomfort. Once the decay has been removed the tooth can then be filled up using conventional filling techniques. Usually a tooth colored white filling is used, which is bonded into the tooth.