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FAQ:  Carious Teeth - Cavities

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Orthodontist says No Cavities while Dentist says Cavities? I am fourteen years old and have had braces for over a year. I have never had a cavity in my life and this even without caps. I recently have went to the dentist to remove my last babytooth and while I was there they took X-rays of my teeth. They informed me that I now have NINE cavities. This doesn't make any sense at all to me because just last month my orthodontist took X-rays of my teeth and found nothing. Is there a chance that my dentist is mistaken? ... Visitor from PA

It is true that if a patient has not flossed between their braces, hasn't brushed well or used a fluoride rinse at night before bed, they can develop decay between their teeth. This is true even if this patient had few decay problems before braces are placed.

It's hard enough for most people to develop a daily flossing habit, even WITHOUT braces. Now with brackets and wires stretching over all the teeth, front to back, just think how many brackets, wires, rubber band elastics and areas BETWEEN the teeth that sticky bacterial plaque will adhere or stick to.

Flossing with full braces on requires the use of a floss threader to loop your floss in between each and every space or contact area between the teeth. The reason a floss threader needs to be used is that floss cannot be snapped down between the teeth from the top, because the orthodontic movement wire blocks the space.

It is more important than ever to floss (with a threader), brush (best with an automatic toothbrush like the Oral B Braun) and to use a fluoride rinse at bedtime. All these preventive steps are to completely get rid of the decay causing bacterial plaque each day, and to do a mini fluoride treatment each night before bed.

As to your original question, it may be that the orthodontist wasn't necessarily looking for decay with his x-rays. Also, without seeing you or looking at your x-rays, there is no way for me to tell if the diagnosis of 9 cavities is correct or not.

Sometimes, if interproximal decay between the teeth is small or incipient (just in the enamel layer,but not through to the inner dentine layer next to the nerve or pulp) many dentists, including myself will give the tooth the benefit of the doubt and "watch" this tooth on future x-rays for signs that the decay is growing and getting bigger requiring a restoration or filling.

Editorial Staff

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