Resin Infiltration: Revolutionizing the Way We Treat Early Caries, Without Drilling

A smile tells a story in more ways than one. It paints a picture of health that is reflected in the vibrancy of expressed emotions. But with many patients, especially younger patients, their smile isn’t telling the story they want it to because of cariogenic white spot lesions. For patients seeking to halt the progression of caries while simultaneously improving their smile aesthetics, a conservative, minimally invasive option that can be accomplished in a single visit is immediately enticing. Icon, the caries infiltration system from DMG, provides the one-two punch to reduce chair time and improve oral health, helping a patient tell the story they want to with their smile. What really makes the product unique is that there’s no drilling or anesthesia required. Plus, it limits the loss of unnecessary tooth structure and has the added benefit of being a low aerosol treatment, an important consideration amidst the pandemic.

Reducing the Physical and Emotional Impact of Enamel White Spots

The burden of tooth decay globally is enormous, with 44% of the population suffering from some form of oral disease. Dental caries is no small matter considering the high prevalence of risk factors for this disease in the modern diet. Sugar, alcohol, and a general lack of good oral hygiene habits contribute to making dental caries a widespread chronic concern. Children in particular are affected by the self-esteem issues that can come with the spots and discoloration of early caries. If early caries aren’t managed in their youth, they may face more expensive and intensive dental treatments as adults.

It’s also important to consider the emotional burden of an unhealthy smile. Oral disease may have debilitating impacts on children, such as social isolation. One survey found that appearance dominated as the main source of bullying among children. Pediatric Dentist Dr. Joel Berg summed up the benefits of using Icon for young patients this way: “The evidence is very clear that lesions can progress 3 to 4 times faster if you don’t use Icon.”


Icon can delay restorations for many years and enable young patients to get on a preventive program to improve their health and confidence.

Preserving Tooth Structure While Enhancing Esthetics? Yes Please

According to the CDC, dental caries is “the most chronic common disease” for children and adolescents between 6 and 19 years old. So, how does resin infiltration combat caries for these patients while preserving healthy tooth structure? There are 3 major components to the treatment:

  1. Opening up the pore structure of the tooth for access to the lesion. This is done with a 15% HCl acid etch gel (Icon Etch)
  2. Previewing what the final result will look like by applying a 99% ethanol alcohol (Icon Dry)
  3. Penetrating the enamel and blocking the progression of the lesion using a low-viscosity liquid resin that is then fully light cured (Icon Infiltrant)

Capillary action pulls the resin deep into pores of the enamel, optically blending the lesion in so it more closely matches the overall tooth aesthetics. This concept of “caries infiltration” was initially created to prevent the development of non-cavitated carious lesions in between teeth or interproximal regions. An unexpected upside to this procedure was soon discovered. White spots on the surface of the tooth structure appeared to fade away due to taking on the appearance of surrounding healthy enamel via light refraction.

Caries infiltration can be effective in a variety of circumstances, from early proximal caries and mild-to-moderate fluorosis to early smooth surface caries. An important consideration to keep in mind is that this treatment is most successful for enamel surface caries or those up to the first third of the dentin.

For smooth surface treatment: Icon resolves discoloration by filling in porous tissue and matching the refractive index of enamel.

For proximal treatment: Icon stops caries progression in its tracks by sealing the enamel. This is a game changer for caries that haven’t yet advanced beyond the outer third of the dentin, especially for children who still have primary dentition.

Critical Case: Decreasing Post-Orthodontic White Spots with Icon for a 16-Year-Old Patient

Icon shines when it is used to remove post orthodontic white spot lesions. In a case from Dr. Nate Lawson, his 16-year-old patient sought a conservative treatment for lesions following orthodontic bracket debonding. Unaesthetic white spot lesions were apparent on teeth #5-#12, with facial cavitation on #10. After rubber dam placement for soft tissue coverage, Dr. Lawson applied Icon Etch for two minutes, a total of three times, until the majority of the spots were no longer visible with the Icon Dry alcohol solution. Dr. Lawson applied the resin Icon Infiltrant in two rounds for three minutes each, light curing all sides for 40 seconds each after application. The result was vastly improved aesthetics that delighted the patient and had the added bonus of hardening the cavitation on #10 enough to delay any surgical intervention.


For optimal success with Icon, clinicians can implement these tips and tricks:

  • Amaze your patients by taking before and after pictures to really emphasize their transformation.
  • Rely on fiber-optic transillumination prior to bitewing x-rays when diagnosing proximal lesions.
  • Use the DMG MiniDam for quick protection in proximal region treatments.
  • Ensure that you are properly etching and not over etching to avoid creating any defect in the tooth structure

Click here to start your Icon journey and get more patients on the path to a healthy smile!