First Step for Dental Innovation “No Cavity”

February 14, 2007 · Posted in innovation, problem solving, strategy 

I had a cavity and the American dentist gave me only one option and I didn’t like it. I wanted better options. So I started innovating to satisfy my desire. Before you think that I started inventing something let me clarify innovation. Innovation is satisfying a demand. If you can find something that already exists and use it to satisfy the demand you innovated. So I began searching. The innovation I wanted was No cavity.

Since I wasn’t an expert on dentistry I did a little research to understand at a high level how dental caries (cavities) function.

Cavities in Dentin Layer of Tooth

Acid from bacteria eat left over food and cause decay in teeth. Your mouth has a natural defense for the acid. Your saliva is alkaline, it neutralizes acid. Unfortunately bacteria can stick to teeth blocking saliva from neutralizing the acid.

Saliva has another positive feature. If the infection that causes decay is caught early enough teeth re-mineralize all on their own using material in your saliva.

If too much damage is done there is a hole that could collect food and bacteria. Once that hole gets through the hard enamel, a cavity can quickly grow in the softer dentin. It’s still possible for a tooth to heal at this point but often some type of repair is needed. But most important is stopping the infection and decay.

Many cavities form in areas of teeth that catch food and are hard to clean. The tendency for bacteria to stick to teeth makes this even worse.

Functional Diagram

Taking all the information I gathered I created a Functional Diagram. The red boxes describe how cavities work. The green boxes describe the process of filling a cavity. And the yellow boxes show the natural process of saliva re-minerizing teeth.

The Functional Diagram give you a high level starting point to start looking for innovation alternatives.

Dental Caries Functional Diagram


Once you have a function diagram the next step in the Predictive Innovation — OutCompete Method is fill out an Alternatives Grid. The grid makes sure we at least think of every type of solution. An Alternatives Grid has at least 15 possible alternatives for every function in the diagram.

Predictive Innovation -- OutCompete Alternatives Grid

The most common approach to dental caries (cavities) is 17. Close the cavity in order to prevent #9. Hole collecting food and bacteria. The way this is done is #14. Remove decay and then #15. Fill the hole with filler.

Improving any of the 17 functions is a possible innovation. Any one of the 17 can help the goal of No Tooth Decay. Since there are minimum of 15 possible alternatives for each function that means there are a minimum of 98.5 quintillion (98,526,125,335,693,359,375) ways of achieving No Tooth Decay. So there is no excuse for 150 years of drill and fill.

There are way too many possible alternatives so focus on just one function at a time.

The standard treatment is 15. Fill the cavity with a foreign filler let’s start there and show all the innovation stemming from the current solution.

The direct alternatives use a foreign filler such as: metal (mercury amalgam), plastic, or other solid materials since liquids and gases escape the cavity and thus cannot perform the purpose.
There are two different types of opposite alternatives.

  1. Use an opposite object for example a non-foreign filler, in this case natural tooth.
  2. Do the opposite action; such as, leave cavity empty. If the cavity is kept empty of food and bacteria then decay is prevented.

The Stable alternatives are:

Use a filling material that is stable to ensure the cavity remains completely filled under any condition. A difference in thermal expansion can cause the filling to become loose. When you drink something cold, filler contracts more than the tooth and opens a channel for bacteria to enter the cavity and cause decay.

Recover filling after its partial removal. If filler becomes smaller than the cavity, there is something that covers the gap. Perhaps a pressurized liquid under the filling that will quirt out and fill gaps. This same technique is used with tires.

Keep cavity filled. Make the filler perfectly stick to the tooth so the cavity is always filled. Something like bubble gum with an antibacterial feature would work.

Current Direct Opposite Keep Stable Return to Stable Make Stable
Fill the cavity with mercury amalgam filler Fill the cavity with solid filler
  • Fill the cavity with tooth’s own material
  • Keep cavity empty, so no food or bacteria can accumulate in it.
Make filler completely fill the cavity under any condition Fill the gaps when it is created Make filler perfectly stick to the surface of cavity

You can see there are already six alternatives before looking at Multiple & Continuous. And remember these are descriptions of alternatives types. You could create many real world alternatives for each type.

The One alternative is easy to imagine because it’s the standard approach. Multiple and Continuous might initially seem harder to imagine but tend to create the greatest innovation.

Multiple deals with some kind of synergy between multiple actions or one action repeated several times or a mixture of multiple alternative objects. For instance, with solid fillers, one means one material, while multiple mean composite from several alternative materials.

Continuous often produces the huge breakthrough innovations. Just like One & Multiple, Continuous can apply to object or the action. An example of Continuous object is using any or all possible fillers. Continuous action would be the cavity is continually filled or refilled.

  Current Direct Opposite Keep Stable Return to Stable Make Stable
One Fill the cavity with mercury amalgam filler Fill the cavity with solid filler
  • Fill the cavity with tooth’s own material
  • Keep cavity empty, so no food or bacteria accumulate.
Make filler completely fill the cavity under any conditions Fill the gap when it becomes large enough Make filler perfectly stick to the surface of cavity
Multiple Fill the cavity several times Fill the cavity with composite material
  • Fill the cavity with tooth’s own material for several times
  • Empty the cavity for several times
Make composite filler that fills the cavity completely Fill the gap multiple times Make composite filler perfectly stick to tooth
Continuous Continuously (on the regular basis) refill the cavity with mercury amalgam filler Fill the cavity with composite material
  • Continuously refill the cavity with tooth’s own material
  • Continuously empty the cavity
Make composite filler that completely fills the cavity Fill the gap continuously Make composite filler perfectly sticking

Now, think about possible alternative solutions.

The Current Alternative is only a one-time solution. If you make the filler refillable, it would work better.

Direct Alternatives

Direct Alternative suggests some other material, such as a composite that combines several features such as: appropriate thermal expansion, chemical stability, mechanical stability, or antibacterial features. We know it’s easier to develop a composite with pre-programmed features than find all the desired characteristics in a single material.

Opposite Alternatives

The Opposite Object Alternative suggests the solution I originally hoped to find, filling the cavity natural with the tooth’s own material.

The Opposite Action Alternative suggests “keep the cavity empty”. You could do this by cleaning, perhaps with air or liquid. You could also “fill the cavity” with non-solid material like a gel sticks to the cavity and has antibacterial features. If the gel has sufficient surface tension it could prevent food from penetrating the cavity. The gel filler could be refilled, for instance, by use of special toothpaste. This option could be used in conjunction with others to rebuild the natural tooth.

Stable Alternatives

The Stable Alternative suggests finding either a very elastic material that always pushes itself against the cavity walls, or very plastic material that sticks to the cavity walls and always fills it completely, or a solid material with absolutely the same expansion features as the tooth. And not just for heat but also expansion under different humidity, pH, and every other possible condition. Remember, if you don’t find a perfect solution but one that is still much better than what you have it’s a viable innovation.

Return to Stable Alternative leads to the various ways to “fill the gap” between filler and cavity. It could be a liquid that penetrates the gap and stays there, it could be a gel that penetrates a gap and remains inside, or even some gas that condenses in the gap to seal it.

Move to Stable Alternative recommends thinking about a thin film covering the surface of a cavity. The film perfectly sticks and protects. This has already been tried with very good success. Making this, easier, cheaper or with less hassle could be quick profitable innovation.


As you can see, without much thought the Predictive Innovation — OutCompete Method generated several alternatives that already look better than “drilling and filling.”

Knowing all the possible types of innovations helps you quickly find good alternatives. It also helps you avoid missing really good ones.

As you can see, 98.5 quintillion options means there are plenty of possible innovations. How many innovations are possible for your business?

In my next article I’ll explore some other functions to find the bigger and better innovations.

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