Small Cavity: no treatment advised! Is that ok?

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Stefano Tirelli - 30 Oct 2005 17:38 GMT

Hello, I am 26 and I had no problems to my teeth to date.
A few days ago I had some moderate pain around my molar, I was worried
and by self-inspection I noticed a small dark hole (about 0.5 mm
diameter) on the outside of a molar. Worried by a cavity, I ran to the
dentist (new dentist, for above reasons), who dimissed me quickly saying
that it was too small do be considered cavity (caries) and it needed to
be monitored and eventually cured if developin, but not now. And pain
was probably due to the wisdom teeth which is coming out now (true).
With my inistence, he said we could get rid of it now with a filling,
even it wasn't necessary.

Now, to my knowledge leaving bacteria in my mouth is not good at any
time, at any size. My question is if I should trust this dentist or not,
even if it was advised by a person I care about a lot. He did and x-ray
to see if there was an intra dental cavity, but was very fast overall.
It must be noted though that my appointmend was squeezed in the morning
schedule cause I was worried, so he probably didn't have much time.
Though to my knowledge it sound strange that a dentist advises to leave
as is a potential receptacle for bacteria.

I don't know much about dentist so, what are your opinion on this?
I know there are far worse problems, but I'd really like to keep my
teeth healthy...

Thanks

Stefano

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Bill - 30 Oct 2005 20:02 GMT

> Hello, I am 26 and I had no problems to my teeth to date.
> A few days ago I had some moderate pain around my molar, I was worried
[quoted text clipped - 23 lines]
>
> Stefano

_________________________________

Most all posterior teeth (molars and premolars) have a number of deep
grooves and pits which are "potential receptacles" for bacteria.
Indeed, many cavities start in just such a location.

However, not every pit or fissure becomes a progressive cavity. Many do
not, which means that a filling in that location would have been
wasted.

The problem is that it is impossible to tell in advance exactly which
pits or fissures will become cavities at some time in the future. In
order to help guard against this, sealants were developed as a
preventive treatment. Sealants don't last forever, though, as they are
thin and eventually are usually worn off.

Some dentists leave such borderline pits alone until they actually show
some carious progression. This is generally safe if the patient returns
on a normal schedule for periodic exams.

I have seen some borderline pits and grooves turn into small cavities
within six months, and have also seen some of them go for twenty or
thirty years with no clinical progression whatsoever.

You have the option of placing a "preventive restoration" in such a pit
if it helps to ease your worry, or you can simply have it carefully
examined every six months by your dentist. He should be examining you
every six months anyway, so there is no extra time or cost involved.

- dentaldoc

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Ann - 30 Oct 2005 21:13 GMT

>> Hello, I am 26 and I had no problems to my teeth to date.
>> A few days ago I had some moderate pain around my molar, I was worried
[quoted text clipped - 51 lines]
>examined every six months by your dentist. He should be examining you
>every six months anyway, so there is no extra time or cost involved.

Cool.. you agree with what I said.. that pleases me!

Ann

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Ann - 30 Oct 2005 20:04 GMT

>Hello, I am 26 and I had no problems to my teeth to date.
>A few days ago I had some moderate pain around my molar, I was worried
[quoted text clipped - 19 lines]
>I know there are far worse problems, but I'd really like to keep my
>teeth healthy...

Sounds like when my dentist says that's one we are going to watch.. I
like that because I know that he's not just trying to get money out of
me for unnecessary procedures. Of course they assume that you are
going to go back for a check up in 6 months or so and not leave it
until you have major problems.

But I'm not a dentist and would be pleased to hear if the dentists
agree with me.

Ann

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DrSteve - 31 Oct 2005 02:57 GMT

Ciao,

I guess we are damned if we want to treat something that the patient does
not feel pain from and we are damned if we don't treat something too small
to warrant cutting good enamel to gain access to. :=)

Seriously, this is a good situation for using the DIAGNOdent. It does
provide extra useful information to help in making these tougher decisions

SM (the other Stefano)

> Hello, I am 26 and I had no problems to my teeth to date.
> A few days ago I had some moderate pain around my molar, I was worried
[quoted text clipped - 23 lines]
>
> Stefano

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Joel M. Eichen - 31 Oct 2005 10:24 GMT

>Ciao,
>
[quoted text clipped - 3 lines]
>
>Seriously, this is a good situation for using the DIAGNOdent.

Exactly. Better to err on the side of caution ........ too many kids
end up with bombed-out molars ...... and every other tooth just
perfect.

Joel

> It does
>provide extra useful information to help in making these tougher decisions
[quoted text clipped - 28 lines]
>>
>> Stefano

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Stefano Tirelli - 01 Nov 2005 14:48 GMT

DrSteve ha scritto:

> Ciao,
>
[quoted text clipped - 4 lines]
> Seriously, this is a good situation for using the DIAGNOdent. It does
> provide extra useful information to help in making these tougher decisions

as far as i see, this is a pro tool that can be used by dentists. So, do
you think I should print the sheet and bring it with me next time?
Might I add "let me handle this" ? :))

> SM (the other Stefano)

Stefano 2 (just joking)

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Amatus Cremona - 01 Nov 2005 16:36 GMT

> as far as i see, this is a pro tool that can be used by dentists. So, do
> you think I should print the sheet and bring it with me next time?
> Might I add "let me handle this" ? :))

Print which sheet, signore?

Signature

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Amatus

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> DrSteve ha scritto:
>> Ciao,
[quoted text clipped - 15 lines]
>
> Stefano 2 (just joking)

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Stefano Tirelli - 01 Nov 2005 17:50 GMT

Amatus Cremona ha scritto:

>>as far as i see, this is a pro tool that can be used by dentists. So, do
>>you think I should print the sheet and bring it with me next time?
>>Might I add "let me handle this" ? :))
> Print which sheet, signore?

The product datasheet... :)

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Amatus Cremona - 01 Nov 2005 18:45 GMT

> The product datasheet... :)

Buon Giorno,

If you mean the data sheet which lists the functions of the device, then I
say don't bother. If you mean the data obtained from the DIAGNOdent on your
individual teeth, then definitely bring them along. They help us decide
whether or not to treat an area almost as much as the radiographs do.

If you are not certain, the DIAGNOdent is a small device which operates off
a few small batteries. It generates a very weak laser light which is
allowed to shine on areas of teeth which do not already have any fillings or
sealants on them. The device them measures the amount of laser light which
is reflected back to the wand. It gives a numerical readout of the amount
of light reflected back to the wand. These numbers then become more
information in the (sometimes difficult) decision making process of whether
or not to treat a specific area. In my hands, I have found the machine to
be very useful. We don't use it on every patient. We use it when we need
more information to help us reach a decision. It is very reliable.

Signature

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Amatus

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> Amatus Cremona ha scritto:
>>>as far as i see, this is a pro tool that can be used by dentists. So, do
[quoted text clipped - 3 lines]
>
> The product datasheet... :)

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Stefano - 02 Nov 2005 16:42 GMT

Amatus Cremona ha scritto:

>>The product datasheet... :)
>
[quoted text clipped - 4 lines]
> individual teeth, then definitely bring them along. They help us decide
> whether or not to treat an area almost as much as the radiographs do.

Well, my point was, as far as I've seen that's a pro device which should
be user by pros dentist in diagnosis. So I'd rather first convince my
dentist to buy it, an that was why i joked about bringing the datasheet
with me. Which I don't think it will be considered really polite :)
On the other side, I may have misunderstood, that being a tool for
self-diagnosis and check. The price would be an interesting indicator on
which of the two categories should it fall :)
Seems there much talk about that device in this group.

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Amatus Cremona - 02 Nov 2005 17:22 GMT

> Well, my point was, as far as I've seen that's a pro device which should
> be user by pros dentist in diagnosis. So I'd rather first convince my
> dentist to buy it, an that was why I joked about bringing the datasheet
> with me. Which I don't think it will be considered really polite :)
> On the other side, I may have misunderstood, that being a tool for
> self-diagnosis and check.

Grazia, I understand your point better now.

The device is great diagnostic device which is bought and used by a dental
professional. Situations like you described can be very difficult to decide
on whether or not to treat it. The DIAGNOdent makes it easier for the
dentist to make that decision. I think it is a fabulous device that every
dentist should own. However, not every dental office will be willing to
invest in technology out of fear created by the cost of it. This device is
inexpensive (in my opinion), but you will still lots of office which will
not invest in it.

Signature

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Amatus

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> Amatus Cremona ha scritto:
>
[quoted text clipped - 17 lines]
> which of the two categories should it fall :)
> Seems there much talk about that device in this group.

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