Questions After the Consultation
Dear Dr.
Lin,
Hello.
Today I visited the dentist for a check-up and had two areas examined: the lower left first molar and the upper right first molar.
The issue with the lower left first molar is that there is a small gap on the surface of the tooth.
I couldn't determine whether it was due to a crack in the tooth, a fallen filling, or the tooth's natural texture, so I asked the dentist to examine it.
After the examination, the dentist explained that it was a crack between two silver amalgam fillings (the tooth has two or three fillings).
I inquired whether the crack could be treated, and the dentist replied that if it were to be treated, all the silver fillings would need to be removed, and a crown or inlay would be required; it wouldn't be possible to simply address the small crack since it is not a cavity and there are no symptoms like tooth pain or sensitivity, so the small crack cannot be directly filled.
I would like to ask Dr.
Lin the following questions:
Q1.
Given the above, can you confirm whether the small crack between the two silver fillings in the lower left first molar, in the absence of a cavity and without tooth pain or sensitivity, truly cannot be addressed by the dentist (for example, by smoothing and polishing the crack) before filling it with composite resin or silver amalgam?
Q2.
Following up on the previous question, since the crack between the two silver fillings is very small and there are no signs of cavities or tooth pain, if no treatment is done and I continue to use this tooth for chewing, will there be any long-term issues?
As for the upper right first molar, the issue is that there is a brown line on the outer side of the tooth, which appears slightly indented.
However, after the dentist examined it and performed an air-blowing test, they stated that the line is flat and will not trap debris, indicating that there is no problem, so no treatment was performed.
I asked the dentist what the brown line was, and they only replied that it is a change in the surface of the tooth.
After returning home, I researched online and found that the brown line seems to resemble signs of dental erosion on the tooth surface.
Q3.
If the brown line on the outer side of my upper right first molar is indeed a sign of dental erosion, even though it is located on the side of the tooth and not on the pressure-bearing chewing surface, if I do not take any action, will this tooth potentially develop any issues in the future?
Thank you, Dr.
Lin.
Kris, 40~49 year old female. Ask Date: 2024/02/28
Dr. Lin Jiayong reply Dentistry
Hello: "Since it is not a cavity and there are no symptoms such as tooth pain or sensitivity," it is recommended to just observe.
Dental insurance provides preventive care and disease treatment.
1.
It is meaningless; adding materials may create occlusal interference, which can quickly fall out after a while.
Occlusal interference may also cause joint discomfort.
2.
It should not be a problem.
Regular check-ups every six months are sufficient.
3.
It should not be a concern; if excessive erosion is confirmed, consider using high-fluoride toothpaste or fluoride mouthwash for improvement.
Reply Date: 2024/02/28
More Info
Hello, thank you for your detailed inquiry regarding your dental concerns. I appreciate your thoroughness in describing your situation, which allows for a more accurate assessment. Let’s address your questions one by one.
Q1: Can the small gap between the silver fillings be treated?
In the case of the small gap between your silver fillings, it is indeed a common concern among patients. If the gap is not associated with any decay or sensitivity, many dentists may hesitate to intervene, as they prioritize preserving tooth structure. However, it is possible to smooth and polish the area to minimize the gap and potentially apply a composite resin to fill it. This approach can help seal the area and prevent food particles from getting trapped, which could lead to decay over time. It’s essential to have a conversation with your dentist about your concerns and the possibility of a conservative approach to treatment, especially if you are worried about the integrity of the fillings.
Q2: What happens if the gap is left untreated?
If the small gap between the fillings is left untreated, and there are no symptoms of decay or sensitivity, the tooth may not experience immediate issues. However, over time, food particles and bacteria can accumulate in the gap, potentially leading to decay. Additionally, if the gap allows for moisture retention, it could create an environment conducive to bacterial growth, which may eventually lead to more significant problems, including the need for more extensive dental work. Regular dental check-ups are crucial to monitor the situation and catch any developing issues early.
Q3: What are the implications of the brown line on the upper right molar?
Regarding the brown line on your upper right first molar, if it is indeed a sign of enamel erosion or acid wear, it is essential to monitor it closely. While your dentist has indicated that it is not a cavity and does not pose an immediate threat, enamel erosion can lead to increased sensitivity and a higher risk of cavities in the affected area. Even if it is not in a high-pressure area for chewing, the compromised enamel can make the tooth more susceptible to decay over time.
To mitigate potential issues, consider the following:
- Dietary Adjustments: Reducing acidic foods and beverages can help prevent further erosion.
- Oral Hygiene: Maintaining excellent oral hygiene practices, including brushing with fluoride toothpaste and using a fluoride mouthwash, can help strengthen enamel.
- Regular Dental Visits: Continue to have regular check-ups with your dentist to monitor the condition of the tooth and address any changes promptly.
Conclusion
In summary, while your current dental conditions do not require immediate intervention, proactive management is essential to prevent future complications. Discussing your concerns with your dentist about the possibility of treating the small gap and monitoring the brown line will help ensure that your dental health remains intact. Regular check-ups and maintaining good oral hygiene practices will be your best defense against potential issues. If you have further questions or concerns, don’t hesitate to reach out to your dental care provider for personalized advice. Thank you for your inquiry, and I wish you the best in your dental health journey!
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