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Medical Forum / General / Dentistry / May 2005Why am I getting so many cavities?
I'm 18 years old. Up until last year, I'd always been told I had great teeth--then I went to a new dentist who found 14 cavities at my first visit (as well as 4 and 5mm periodontal pockets and receeding gums). This new place has a lot of fancy equipment and is much more high-tech than my old dentist, so I'm inclined to trust them. I've been going every three months for a cleaning, and every time, they've found new cavities. I can even see little black lines forming in my molars, and I think I see some on the back side of my front teeth. I brush two or three times a day and floss twice a day--always. I don't eat refined sugar, drink soda, eat candy, etc. I do eat a lot of fruit though. If I ever snack between meals it's on something like vegetables. I can't figure out why my teeth are in such bad shape, especially at my age. Most of my family has good teeth. No matter how well I take care of my teeth, it seems like they just keep getting worse and more cavities keep forming. Any ideas on why this might be happening? Or what I can do to prevent the cavities? > I'm 18 years old. Up until last year, I'd always been told I had great > teeth--then I went to a new dentist who found 14 cavities at my first > visit (as well as 4 and 5mm periodontal pockets and receeding gums). How frequently did you have dental checkups before seeing this new dentist? If it had been years, rather than months, then you may be addressing many years' worth of problems. > This new place has a lot of fancy equipment and is much more high-tech > than my old dentist, so I'm inclined to trust them. All it takes to get fancy equipment is money, not skill or expertise. And the money can even be borrowed. Skill can't be borrowed. You may well have had 14 cavities -- I can't tell from here. But when your new dentist suggests a massive plan of treatment, it could be a good idea to seek a second opinion, preferably from an experienced dentist with a good reputation. It is unusual for a teenager to have actual 5mm periodontal pockets, involving the bone loss of periodontitis. Most often, a 5mm measurement at age 18 is due to incomplete eruption, or to gingivitis caused by poor oral hygiene. If these 5mm measurements are merely due to gingivitis, then a professional cleaning and a reliable program of home care (flossing and careful brushing daily) should quickly reduce them. If not, it would be wise to consult a periodontist to determine why this condition exists and persists. > I've been going every three months for a cleaning, and every time, > they've found new cavities. I can even see little black lines forming > in my molars, and I think I see some on the back side of my front > teeth. It is highly unusual for brand new cavities to develop every three months in a person with good diet and oral hygiene. It would be interesting to learn what a second opinion might find. > I brush two or three times a day and floss twice a day--always. I > don't eat refined sugar, drink soda, eat candy, etc. I do eat a lot of > fruit though. If I ever snack between meals it's on something like > vegetables. So far, so good. > I can't figure out why my teeth are in such bad shape, especially at my > age. Most of my family has good teeth. No matter how well I take care [quoted text clipped - 3 lines] > Any ideas on why this might be happening? Or what I can do to prevent > the cavities? It is impossible to make a determination over the Internet. A second opinion would be very helpful, as a dentist could then examine your teeth and gums in detail. What has your present dentist said about these unusual conditions? - dentaldoc > How frequently did you have dental checkups before seeing this new > dentist? If it had been years, rather than months, then you may be > addressing many years' worth of problems. I went every six months to my old dentist. I think it was about eight months after my last visit to the old dentist that I saw the new one. > You may well have had 14 cavities -- I can't tell from here. But when > your new dentist suggests a massive plan of treatment, it could be a > good idea to seek a second opinion, preferably from an experienced > dentist with a good reputation. That's a good point. What do you think about going to the dental clinic at a local university? They have no financial bias, but I'm not sure how skilled the people there are. > It is unusual for a teenager to have actual 5mm periodontal pockets, > involving the bone loss of periodontitis. Most often, a 5mm measurement > at age 18 is due to incomplete eruption, or to gingivitis caused by > poor oral hygiene. The dentist insisted that I have bruxism, and fitted me with a nightguard ($600...sigh). He speculated that the night grinding was causing the pockets--he agreed that it's very unusual for someone my age to have them so deep. Especially because my gum tissue is otherwise healthy (very little bleeding or puffiness). > What has your present dentist said about these unusual conditions? He said that my old dentist did a shoddy job, not recognizing my bruxism and not acting quick enough on the cavities that were forming. He said a lot of this could have been prevented if I had been coming to their office years before. The new dentist uses some type of laser that gives decay readings, so that cavities are caught before they even show up on X-ray--so some of those 14 cavities were just in the beginning stages. The new dentist also says some of my periodontal problems are from a bad occlusal, and that I'll eventually need braces. (I'm a little weary of this, though, since my teeth are extremely straight. The only problem I've had with my bite came after I got those 14 cavities filled--a lot of the fillings were high and only a few teeth touched when I bit down. Got that fixed, though.) Thanks for your help! > > How frequently did you have dental checkups before seeing this new > > dentist? If it had been years, rather than months, then you may be > > addressing many years' worth of problems. > > I went every six months to my old dentist. I think it was about eight > months after my last visit to the old dentist that I saw the new one. REPLY Why did you deep-six the old dentist? LEAVE the old dentist? Joel > > You may well have had 14 cavities -- I can't tell from here. But when > > your new dentist suggests a massive plan of treatment, it could be a [quoted text clipped - 4 lines] > clinic at a local university? They have no financial bias, but I'm not > sure how skilled the people there are. HAH! The dental schools? They will convince you to get all poreclain veneers on your teeth! Those guys are into learning and gaining experience, never into considerate patient care. > > It is unusual for a teenager to have actual 5mm periodontal pockets, > > involving the bone loss of periodontitis. Most often, a 5mm [quoted text clipped - 14 lines] > He said a lot of this could have been prevented if I had been coming to > their office years before. Ahahhhhh. Unethical comments by Mr. NewDentist. > The new dentist uses some type of laser > that gives decay readings, so that cavities are caught before they even > show up on X-ray--so some of those 14 cavities were just in the > beginning stages. Its called Diagnodent, and is valuable if used in conjunction with other diagnostic procedures. > The new dentist also says some of my periodontal problems are from a > bad occlusal, and that I'll eventually need braces. (I'm a little [quoted text clipped - 4 lines] > > Thanks for your help! > Why did you deep-six the old dentist? I moved 1500 miles away. > > Why did you deep-six the old dentist? > > I moved 1500 miles away. That's a good reason ....... dentists cannot be stuffed into the trunk of a car without complaining too much. Joel >He said that my old dentist did a shoddy job, not recognizing my >bruxism You need an NTI -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > I'm 18 years old. Up until last year, I'd always been told I had great > teeth--then I went to a new dentist who found 14 cavities at my first > visit (as well as 4 and 5mm periodontal pockets and receeding gums). How frequently did you have dental checkups before seeing this new dentist? If it had been years, rather than months, then you may be addressing many years' worth of problems. > This new place has a lot of fancy equipment and is much more high-tech > than my old dentist, so I'm inclined to trust them. All it takes to get fancy equipment is money, not skill or expertise. And the money can even be borrowed. Skill can't be borrowed. You may well have had 14 cavities -- I can't tell from here. But when your new dentist suggests a massive plan of treatment, it could be a good idea to seek a second opinion, preferably from an experienced dentist with a good reputation. It is unusual for a teenager to have actual 5mm periodontal pockets, involving the bone loss of periodontitis. Most often, a 5mm measurement at age 18 is due to incomplete eruption, or to gingivitis caused by poor oral hygiene. If these 5mm measurements are merely due to gingivitis, then a professional cleaning and a reliable program of home care (flossing and careful brushing daily) should quickly reduce them. If not, it would be wise to consult a periodontist to determine why this condition exists and persists. > I've been going every three months for a cleaning, and every time, > they've found new cavities. I can even see little black lines forming > in my molars, and I think I see some on the back side of my front > teeth. It is highly unusual for brand new cavities to develop every three months in a person with good diet and oral hygiene. It would be interesting to learn what a second opinion might find. > I brush two or three times a day and floss twice a day--always. I > don't eat refined sugar, drink soda, eat candy, etc. I do eat a lot of > fruit though. If I ever snack between meals it's on something like > vegetables. So far, so good. > I can't figure out why my teeth are in such bad shape, especially at my > age. Most of my family has good teeth. No matter how well I take care [quoted text clipped - 3 lines] > Any ideas on why this might be happening? Or what I can do to prevent > the cavities? It is impossible to make a determination over the Internet. A second opinion would be very helpful, as a dentist could then examine your teeth and gums in detail. What has your present dentist said about these unusual conditions? - dentaldoc > It is unusual for a teenager to have actual 5mm periodontal pockets, > involving the bone loss of periodontitis. Most often, a 5mm measurement > at age 18 is due to incomplete eruption, or to gingivitis caused by > poor oral hygiene. Maybe they found Undiagnosed and untreated Juvenile Periodontitis? This would be evident around the first molars and perhaps around the anteriors. It doesn't go away, and only gets worse. If I was femme, I'd want to get this ruled out by a competent periodontist. Just my suggestion SP  SignatureFinally: take out the TRASHH > I'm 18 years old. Up until last year, I'd always been told I had great > teeth--then I went to a new dentist who found 14 cavities at my first > visit (as well as 4 and 5mm periodontal pockets and receeding gums). I just bet it was a new dnetist, right? Joel > This new place has a lot of fancy equipment and is much more high-tech > than my old dentist, so I'm inclined to trust them. HUH????? So owning fancy gizmos ensures ethics? > I've been going every three months for a cleaning, and every time, > they've found new cavities. I can even see little black lines forming [quoted text clipped - 13 lines] > Any ideas on why this might be happening? Or what I can do to prevent > the cavities? DNETIST, dentist, whatever ....... I still bet he is new to you! Joel > > I'm 18 years old. Up until last year, I'd always been told I had great > > teeth--then I went to a new dentist who found 14 cavities at my first [quoted text clipped - 28 lines] > > Any ideas on why this might be happening? Or what I can do to prevent > > the cavities? > I just bet it was a new dnetist, right? He was new to me, but not new as a dentist (he has 25 years of experience, I believe). > > I just bet it was a new dnetist, right? > > He was new to me, but not new as a dentist (he has 25 years of > experience, I believe). YUP, new TO YOU ,,,, and you were new to him. Joel I vote for, get a second opinion at the school dental clinic. ares > > I just bet it was a new dnetist, right? > > He was new to me, but not new as a dentist (he has 25 years of > experience, I believe). > This new place has a lot of fancy equipment and is much more high-tech > than my old dentist, so I'm inclined to trust them. [quoted text clipped - 3 lines] > > Any ideas on why this might be happening? That explains how they finance the fancy equipment, anyway... Bah! Much of the new technology ends up being free to the dental office as it merely displaces other costs. Digital radiography turns out to be cheaper than running film, so *no cost*. CEREC machine is cheaper than the lab bill plus second appointment so *no cost*. Digital records is cheaper than running paper so *no cost*. Lasers and intra oral cameras don't displace other costs, so have to be figured into higher costs, but the average I/O camera today is less than $5K and you can get a portable laser for $12K. Operating microscopes are "relatively" cheap now-a-days. I don't think you can classify a high tech office as having higher costs. It is simply the type of tools chosen to work with. Signature~+--~+--~+--~+--~+-- Stephen [What's a Temporary?], D.D.S. Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >> This new place has a lot of fancy equipment and is much more [quoted text clipped - 7 lines] > > That explains how they finance the fancy equipment, anyway... > Bah! > [quoted text clipped - 8 lines] > can classify a high tech office as having higher costs. It is simply the > type of tools chosen to work with. Even if you are correct that the above items are "no cost", (and I doubt that you will receive universal agreement from your peers) that does not mean "no investment"; so there is surely a cash flow impact that will be hard for many to manage. Also, (Business 101) if you do not have adequate volume in your practice, you will never be able to realize the efficiency improvments possible with these goodies and they will not turn out to be "no cost". Vaughn Digital radiography for instance. In 1998 with no RDH it cost me $4K a year to run film The digital system was $16K regardless of how much I use it and has no ongoing cost associated with it. If I never increased volume and there was zero inflation, It would have been free after the 4th year. Bringing in the RDH in 1999, increasing the amount of images made (due to normal use between myself and RDH) plus inflation, meant it was free slightly into the 3rd year. That was January 1999 I installed it. I now have a few years of a few thousand dollars saved each year. CEREC technology, you do need a certain volume of work to make it "free". It works out to 6-8 units a month. Depends on your hourly overhead. Digital records requires an initial expenditure of cash and time to get it up and running, but it saves you one entire staff person's salary per year (again I am comparing to 1998 costs here). You don't just factor in paper, pen, pencils, forms, custom printing, etc. You also figure in the time that you no longer spend handling paper. I found it was virtually 50% of my staffs day. Payroll savings paid for the system in less than 2 years. Save a few thousand every year for 5 years, then upgrade hardware for half the cost of one staff person's salary for the year. Still saved money that 5th year, just not as much. I would go so far as to say the above technology will actually put money in your pocket after a couple of years. Signature~+--~+--~+--~+--~+-- Stephen [What's a Temporary?], D.D.S. Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >> Bah! [quoted text clipped - 24 lines] > > Vaughn > Even if you are correct that the above items are "no cost", (and I > doubt that you will receive universal agreement from your peers) that does [quoted text clipped - 3 lines] > improvments possible with these goodies and they will not turn out to be "no > cost". Vaughn has said succinctly and in more objective terms what is was I was trying to say. <Actually, the Pipe held his tongue on purpose, to let Vaughn look smart...> SP SignatureFinally: take out the TRASHH > Bah! > [quoted text clipped - 5 lines] > other costs, so have to be figured into higher costs, but the average I/O > camera today is less than $5K and you can get a portable laser for $12K. Portable laser burns are free... To learn to avoid them, and to give your patients the best chances of never getting them, you need a laser that spits water as an integral part of its functioning. These lasers are a 'tad' more $$$ than that little 12K thing that is being pushed like crazy in the throw-away literature. You are right that they don't displace other costs, hence one must charge the fair market value and market like crazy to attract the kind of... <ahem> (im)paitents that want and seek those treatments. > Operating microscopes are "relatively" cheap now-a-days. I don't think you > can classify a high tech office as having higher costs. It is simply the > type of tools chosen to work with. That depends on the amount of working capital the dentist has to start with to offset the costs and give him/her a hand in establishing payments. Just my chicken scratchin's SP SignatureFinally: take out the TRASHH |
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