dentists pointing out decay that really isn't

[december]

Husband took 7 year old son to the dentist who diagnosed him with a couple of cavities. Dentist showed my husband where these cavities were, on the tops of two of his molars, and my husband said he could see what the dentist was talking about, but then when he tried to show me, neither one of us could find them. I decided to take him for a second opinion. As soon as dentist #2 found out who dentist #1 was, she acted like I was doing something wrong bringing him in for a second opinion and kept raving about how dentist #1 was the best dentist in the area. She checked my son's mouth, looked confused, looked at the X rays dentist #1 had done, still was confused, so she did her own X rays and then diagnosed with my son with an additional bunch of cavities on top of the ones that dentist #1 had found. Once she saw the X rays then she could point out where the cavities were to me, which were areas that were just slightly a different shade of white. I was so skeptical about the whole thing because how bad of cavities could they be if they could only be seen once you know what to look for on an X ray? Not to mention just her whole attitude of how dare you question dentist #1 made me feel like she had some other agenda than giving an honest 2nd opinion.

So I was paralyzed with indecision for a few months trying to decide what to do when I learned about silver diamine fluoride and decided surely this was the solution! So I asked dentist #1 about using it and he said it would be unlikely to work because my son's cavities were all in between his teeth. What?? He had never said anything about the cavities being in between the teeth before, so I decided this dentist could not be trusted, if he was changing the story now. I took all my kids to dentist #3 and didn't mention anything about a second opinion, just acted like it was a regular check up. Dentist #3 diagnosed my son with multiple cavities in between his teeth. Said that his teeth looked perfect just looking inside his mouth, but that there was decay in between the teeth that couldn't be seen except on an X Ray. So it corroborates exactly with what Dentist #1 put in my son's dental chart but not at all with what we were verbally told.

So my question is why did I have two dentists physically pointing out decay to us when none of the decay can visually be seen? Why didn't they just say what Dentist #3 did, that the decay was all between the teeth?

 

[december]

My second question would be is it common to have no tooth pain, but need a pulpotomy? That is what dentist #3 is recommending. She seems trustworthy and I really don't want to go get a fourth opinion because that's getting really excessive, but it is nagging at me that my son has absolutely no pain or any other issues with his teeth, yet supposedly the pulp is affected? How does that work?

 

[svor1988]

Dental professionals in my area seemed to have each others back as well. My best interests were always beneath theirs and these professionals kept me in the dark about my best interests.

Though it does sound like the 2 independent dentists found something. I'm no dentist, hopefully somebody else answers here.

The cavity had reached the pulp? If not, try a different diet. Make sure he's really brushing (soft bristles) and rinsing hard too... not just spitting out the toothpaste whole (like I did when I was young because I hated the taste, I'd just pretend when mother was around).

I take it this is a permanent tooth? Seems odd that there is a cavity this soon.

I'm skeptical of silver diamine fluoride. Yes silver has an antibacterial effect, and fluoride makes a nice chemically inert barrier (e.g. teflon)- but I'm concerned about unknown chemistry, ingestion/adsorbtion, and unknown interactions with the body (including possible immune reactions which can affect one person but not the next).

I've had luck with bacterial treatments for reversing and removing superficial decay: http://bmcoralhealth.biomedcentral.com/articles/10.1186/1472-6831-10-18 Way better than a dentist drill permanently removing the affected enamel...

 

[svor1988]

*fluorine makes a nice chemically inert barrier

Fluorine was the appropriate word to use there, not fluoride.

 

[Plaza Dental Group]

As far as your question is concerned, in my opinion sometimes a dentist can tell you have a cavity just by looking in your mouth. There are many ways that a dentist can detect a cavity. Your dentist may question your overall oral health, and will examine your teeth for any soft spots or sensitivity while using dental instruments. X-rays are also helpful in determining the seriousness of a cavity. The dentist looks at your tooth to see if there are any weaknesses, usually a brown spot or some other sort of abnormality. If your dentist uses magnification, that is VERY helpful in differentiating between decay and stains. You can help prevent cavities by regularly visiting the dentist, brushing twice a day with fluoride toothpaste and cleaning daily between your teeth with dental floss.