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FAQ:  Carious Teeth - Cavities

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Carious Teeth Dentistry Ask The Dentist Richard Winter Question:
Cavity Diagnosis with different dentists: After visiting 3 dentists, and receiving xrays each time, I was diagnosed 3 completely different ways.

The first dentist used a machine and told me I have three cavities on the top surfaces of my teeth.

The second dentist told me that I only have one cavity on the top surface of my teeth from xrays and looking.

The third told me that I have 4 cavities on the left side of my mouth in between my teeth.

In general, I take care of my teeth, see a dentist every six months. This is annoying. Who is telling the truth, when each dentist told me different teeth have cavities? If they are all cavities, I have like 8 cavities in a matter of 6 months, when I only have two small ones filled now. ... Visitor from UT

Answer:
This is a good but tough question.

First you must realize that dentistry is an art and a science. The guidelines for what determines when a "cavity" should be filled are guidelines.

Some dentists rely solely on sharp explorers and x-rays, others use diagnodent cavity detecting lasers, and others use stains, optical telescopes in combination with the above.

The question is can they show you the cavities? Can they show you the numbers on the diagnodent and explain them? Did they show you the cavities on x-rays, intra-oral television cameras or with a hand mirror?

If you have small cavities, the dentist that found fewer caries may have a different philosophy from the dentist that found more. Who is right? Perhaps both.

Seems like a cop-out but the fact is that each dentist has care, skill, knowledge, and judgement that may have led them to a philosophy that has worked well for them.

If you are concerned about how you were taught about your caries, perhaps you can wait 6 months and have them re-x-ray your teeth and show you the progression via x-rays or show you that the diagnodent readings are increasing.

If they are small and no changes are occurring you may opt to wait, use home fluoride and revisit them in 6 months or a year.

If they are half way through the dentin and the dentist show a progression, then it would be adviseable to restore the teeth while the cavities are small, in enamel (fillings bond better to enamel than when they are deeper and into the dentin) and less expensive.

I hope this helps, when all else fails go with the dentist that educates you the best! Best of luck,

Wisconsin Reconstructive Implant Dentistry
Wisconsin Prosthodontics
Richard Winter, DDS MAGD
Winter Dental Associates
Hampton Dental Associates
5323 W. Hampton Avenue
Milwaukee Wisconsin WI 53218
(414) 464-9021

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