Is Enlarging Tooth Gaps Healthy? A Patient's Experience with a New Dentist

Q: Is Enlarging Tooth Gaps Healthy? A Patient's Experience with a New Dentist

Hello： Based on your description, it is strongly recommended to discuss this matter with the responsible physician at the clinic first.

Is the gap between the first lower right molar, which was created by the dentist's drill (without any cavities), healthy?

Last week, after a routine dental check-up and cleaning, the dentist mentioned that I needed a filling because the crown on my upper right first molar had developed a small crack, resembling a cavity.
The young dentist, who seemed to be around 25 years old and just graduated, noted that the crack had been there for about 3 to 4 years without any issues.
On December 23rd (Monday), the same young dentist asked me, "Does it hurt?" I replied, "No," although I had felt some sensitivity in my teeth after the cleaning he performed the previous week.
He then stated, "The cavity has progressed!" Last week, he appeared uncertain and suggested scheduling a filling for the next visit, but this week he wanted me to consider removing the crown and replacing it, or filling it and waiting until it decayed further before extraction.
I looked at the X-ray on the screen and did not see any cavities, and the dentist did not point any out.
Moving on to the main issue, the originally scheduled filling was not performed.
He began examining my lower first molar, and suddenly said, "I'll help you 'open up the interproximal spaces' a bit; this is better for your 'dental health'!" He mentioned that the spaces would become larger, but I shouldn't think that larger spaces are bad.
I was taken aback! At that moment, my mouth was completely occupied with the suction and water, preventing me from speaking.
He was working on my teeth while asking these questions, and I was unsure if he was serious or intentionally damaging my teeth.
I felt powerless to stop him, and he didn’t give me a chance to consider my options.

As a side note, while he was working on my teeth, the nurse and the dentist were chatting about everything from their parents to amusement parks, laughing the whole time! When the nurse went to get something, she even placed the light instrument on me.
This was my first visit to this dental office, and I was assigned to a newly graduated dentist who had only been there for a few months.

After reflecting on the situation, I felt increasingly uneasy and decided to ask a professional.
The next day, December 24th (Tuesday), while eating, I noticed that a lot of food was getting stuck in the interproximal space of my lower right first molar! What should I do about this? Is there a way to seek recourse or remedy my teeth? Is this normal?

RON, 20~29 year old female. Ask Date: 2019/12/27

Dr. Lin Jiayong reply Dentistry

Hello: Based on your description, it is strongly recommended to discuss this matter with the responsible physician at the clinic first.

Reply Date: 2019/12/27

More Info

Enlarging tooth gaps, or intentionally creating larger spaces between teeth, is a concept that can be quite controversial in dentistry. The experience you’ve described raises several important points regarding dental care, patient communication, and the implications of dental procedures.

Firstly, it’s essential to understand that the health of your teeth and gums is paramount. The idea that increasing the size of tooth gaps can be beneficial is not widely accepted in traditional dentistry. In fact, larger gaps can lead to several issues, including food impaction, which you have already experienced. When food gets trapped between teeth, it can lead to plaque buildup, which may cause cavities and gum disease over time. Therefore, while some dentists may suggest that larger gaps can facilitate better cleaning or alignment, this is not universally true and can often lead to more problems than it solves.

In your case, the young dentist's approach seems questionable. The fact that he suggested enlarging the gaps without a clear explanation or justification raises concerns about his understanding of dental health. It’s also troubling that you felt unable to communicate your concerns during the procedure due to the equipment in your mouth. Effective communication between a dentist and a patient is crucial for ensuring that the patient understands the rationale behind any treatment and feels comfortable with the decisions being made.

Moreover, the inconsistency in the dentist's diagnosis regarding your tooth's condition is alarming. Initially, he indicated that there might be a cavity, but later suggested that you might need to replace the crown. This lack of clarity can lead to confusion and mistrust. If you are uncertain about the diagnosis or treatment plan, it is always advisable to seek a second opinion from another qualified dentist. This can provide you with a clearer understanding of your dental health and the best course of action.

Regarding your immediate concern about food getting stuck in the enlarged gaps, this is not a normal or healthy situation. It indicates that the adjustments made to your teeth may not have been appropriate. You should consider returning to the dentist to discuss your concerns and seek a solution. If the dentist is unresponsive or dismissive, it may be time to find a new dental provider who prioritizes patient care and communication.

In summary, while some dental practices may advocate for certain adjustments to tooth spacing, the general consensus in dentistry is that maintaining proper alignment and spacing is crucial for oral health. Enlarging tooth gaps without a clear, evidence-based reason can lead to complications. Always prioritize your comfort and understanding in dental care, and don’t hesitate to seek second opinions when in doubt. Your dental health is too important to leave in the hands of someone who does not communicate effectively or provide clear, justified treatment options.

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