Common Questions About Cavities: Diagnosis and Prevention

Questions related to cavities?

I have been regularly visiting the dentist, and my previous dentist always said that I had no cavities.
However, I recently saw a different dentist who told me that I have many cavities, all located between my teeth, and after drilling, he said each one was very deep.
I would like to ask: 1.
Is it possible to have deep cavities without feeling any discomfort? 2.
My cavities are concentrated in my upper teeth; are there any other methods to prevent this? 3.
Why was the first dentist unable to detect the cavities? 4.
The dentist said that the last tooth on the upper right (tooth #17) cannot be filled because the cheek tissue would obstruct it.
Is this true, or should I consider seeing another dentist? Thank you.

House, 20~29 year old female. Ask Date: 2016/02/08

Dr. Zeng Guanghui reply Dentistry

1.
Cavities in between teeth are sometimes not visible to the naked eye and can only be detected by probing the tooth structure or taking X-rays.
2.
Cavities are primarily concentrated in the upper teeth, so it is essential to develop a habit of brushing and flossing after meals and to minimize the intake of acidic foods.
3.
If the cavity between the teeth is not severe and the patient does not feel any discomfort, it may go unnoticed.
4.
For the last upper molar with a cavity, if the decay is on the buccal or distal surface, it is generally more challenging to fill due to the obstruction from the buccal mucosa, and it may be advisable to seek further evaluation from another dentist.

Reply Date: 2016/02/08

More Info

Cavities, also known as dental caries, are a common dental issue that can develop without noticeable symptoms, especially in their early stages. Here’s a comprehensive response to your questions regarding cavities, their diagnosis, prevention, and some insights into your specific situation.

1. Asymptomatic Deep Cavities: Yes, it is entirely possible to have deep cavities without experiencing any pain or discomfort. Cavities often begin as small areas of demineralization on the tooth surface, which may not cause any immediate symptoms. As they progress deeper into the tooth, they can reach the dentin and even the pulp without causing noticeable pain, especially if the nerve endings are not yet affected. This is why regular dental check-ups are crucial, as dentists can detect these issues before they become symptomatic.

2. Prevention of Cavities: Since you mentioned that your cavities are concentrated in the upper teeth, there are several preventive measures you can take:
- Oral Hygiene: Maintain a rigorous oral hygiene routine that includes brushing twice a day with fluoride toothpaste and flossing daily to remove food particles and plaque from between your teeth.

- Dietary Choices: Limit sugary snacks and beverages, as sugar feeds the bacteria that cause cavities. Instead, focus on a balanced diet rich in fruits, vegetables, whole grains, and dairy products.

- Fluoride Treatments: Ask your dentist about fluoride varnishes or gels that can help strengthen your enamel and make your teeth more resistant to decay.

- Dental Sealants: Consider getting dental sealants, which are protective coatings applied to the chewing surfaces of the back teeth to prevent cavities.

- Regular Dental Visits: Continue to see your dentist regularly for cleanings and check-ups, as they can catch issues early and provide professional advice tailored to your needs.

3. Missed Cavities by Previous Dentist: There could be several reasons why your previous dentist did not detect the cavities. It’s possible that the cavities were in areas that were difficult to visualize, such as between teeth or under existing restorations. Additionally, different dentists may have varying levels of experience and diagnostic techniques. Some may rely more on visual examinations, while others may use X-rays more extensively to detect hidden cavities. If you feel that your previous dentist was not thorough, it’s reasonable to seek a second opinion.

4. Treatment of Tooth #17: Regarding your upper right last tooth (tooth #17), if your dentist has indicated that it cannot be filled due to the position of the surrounding gum tissue, this could be a valid concern. In some cases, the anatomy of the mouth and the position of the gums can make it challenging to access certain teeth for restorative procedures. However, it’s essential to ensure that you are comfortable with the treatment plan. If you have doubts about the advice given, it is perfectly acceptable to seek a second opinion from another dentist. They may offer alternative solutions or confirm the assessment of your current dentist.

In summary, while cavities can develop without noticeable symptoms, maintaining good oral hygiene, making informed dietary choices, and regularly visiting your dentist are key strategies for prevention. If you have concerns about your dental care or the assessments made by your dentist, don’t hesitate to seek further opinions to ensure you receive the best possible treatment. Your oral health is crucial, and being proactive about it will help you maintain a healthy smile.

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