Cavities, Gum Recession, and Fluoride Treatment Options

Q: Cavities, Gum Recession, and Fluoride Treatment Options

Hello： Based on what you mentioned, I also believe that the best treatment option at this time should be the application of high-concentration fluoride, which not only helps in caries prevention but also provides sensitivity relief. <br>Given your age, you may consider visiting a

Tooth decay, gum recession, and fluoride application?

Hello, I am currently in my twenties.
A few months ago, I had my semi-annual dental check-up and cleaning.
A few days after the appointment, I noticed that the second tooth from the canine on the upper row, near the gum line, felt sensitive when I scraped it with a hard object like my fingernail or the end of a dental floss stick (indicating a potential new cavity that the dentist did not detect or address during the examination).
I called the clinic, and the nurse advised me to apply toothpaste to the area and monitor it.
For a few days, I felt like it was okay, but after a few months, the situation remains the same.
Although the tooth does not appear discolored, I can still feel sensitivity when I scrape a certain line on the tooth, suggesting a possible cavity.
Currently, besides using dental floss and a toothbrush with toothpaste, I have been using a fluoride mouthwash daily for several weeks.
However, I am unsure what my next steps should be.
I would like to ask a few questions:
1.
Since the affected area is on the front of the tooth and near the gum line, if I visit the dentist, will they likely drill it out and fill it with resin?
2.
If I have slight gum recession (over the past five years, one dentist mentioned it, another confirmed it upon inquiry, while about three others did not bring it up), and I hope to achieve a level of gum health similar to my peers, will the resin filling near the gum line prevent the gums from attaching after any potential gum surgery?
3.
Would it be strange to request fluoride treatment at the clinic? I prefer to use fluoride treatment to allow the tooth to heal naturally (considering gum health and aesthetics), but I am unsure if it is too late given my situation (currently, I feel sensitivity when scraping a certain line, but the exterior does not appear discolored, and I do not feel discomfort during daily activities or eating).
If I were the dentist, how would I plan the treatment? Additionally, I have heard that children receive fluoride treatments at dental clinics, which seem to be covered by health insurance, but throughout my childhood, even with cavities and a tendency to develop them, I was never proactively given fluoride treatments.
Is this normal? Should I continue visiting the same clinic? Thank you for your time.

zero zero zero zero, 20~29 year old female. Ask Date: 2021/07/25

Dr. Lin Jiayong reply Dentistry

Hello: Based on what you mentioned, I also believe that the best treatment option at this time should be the application of high-concentration fluoride, which not only helps in caries prevention but also provides sensitivity relief.
Given your age, you may consider visiting a larger medical facility or clinic for fluoride treatment at your own expense, or you can use a high-fluoride toothpaste (greater than 1000 ppm) on a long-term basis.
Sincerely, Lin Chia-Yung, Department of Dentistry, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2021/07/25

More Info

Understanding cavities, gum recession, and fluoride treatment options is crucial for maintaining oral health, especially for someone in their twenties like yourself. Let's break down your concerns and questions regarding your dental situation.

1. Cavity Treatment: If you visit a dentist regarding the sensitivity you're experiencing near your gum line, they will likely conduct a thorough examination, possibly including X-rays, to assess the extent of any decay. If a cavity is confirmed, the dentist may recommend removing the decayed portion of the tooth and filling it with a composite resin (tooth-colored material). This is a standard procedure and is done to prevent further decay and restore the tooth's function. The dentist will discuss the treatment plan with you, including the materials used and the expected outcomes.

2. Gum Recession: You mentioned experiencing mild gum recession. Gum recession can expose the roots of your teeth, leading to sensitivity and increasing the risk of cavities in those areas. If a cavity is filled near the gum line, it is possible that the gum tissue may not reattach to the tooth as it would with natural enamel. However, maintaining good oral hygiene and possibly undergoing treatments for gum health (like scaling and root planing) can help manage gum recession. If the recession is significant, your dentist might refer you to a periodontist for further evaluation and possible surgical options to restore gum tissue.

3. Fluoride Treatments: Requesting a fluoride treatment at your dental visit is not unusual, especially if you are concerned about cavities. Fluoride can help remineralize early decay and strengthen enamel, making it an effective preventive measure. Many dentists offer fluoride treatments, and it’s particularly beneficial for individuals who are prone to cavities. If you express your concerns about sensitivity and potential cavities, your dentist will likely support your request for fluoride application.

Regarding your experience with fluoride treatments in childhood, it is common for pediatric dental practices to offer fluoride treatments as part of preventive care. However, not all dental offices may have the same protocols, and some may focus more on restorative treatments rather than preventive ones. If you feel that your current dental practice is not addressing your preventive care needs adequately, it may be worth seeking a second opinion or finding a dentist who emphasizes preventive care.

In summary, here’s how I would approach your situation if I were your dentist:
- Initial Examination: Conduct a thorough examination to assess the sensitivity and check for cavities.

- Treatment Plan: If a cavity is found, discuss the option of filling it with composite resin and explain the procedure.

- Gum Health: Evaluate the extent of gum recession and discuss possible treatments to improve gum health.

- Fluoride Application: Offer fluoride treatment as a preventive measure to strengthen enamel and help with any early signs of decay.

- Ongoing Care: Emphasize the importance of regular dental check-ups and good oral hygiene practices to prevent future issues.

Your proactive approach to your dental health is commendable, and addressing these concerns with your dentist will help you maintain a healthy smile. Don't hesitate to ask questions during your visit; a good dentist will appreciate your engagement in your oral health care.

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