<p>I know there is a wealth of expertise on this site about wisdom teeth removal. Here’s another topic: Has anyone had any experience with the laser tool that detects very early decay? My concern is not the assessment but the recommended treatment. Dentist is suggesting some restoration at this point for some teeth and maybe sealants for others. This for the patient who has had about 3 cavities in 20 years. Could this be overkill? Would it be advised to “wait and see” if these areas develop into full blown cavities? Any thoughts would be welcomed. THanks.</p>
<p>bluejay, I have a little bit of knowledge on this. It’s not that these are not “full blown cavities,” but that the laser can detect cavities that xray or an explorer may not. Any time a more powerful technology or tool like this comes into use, there will be people who question the validity, possibly even feeling as if the doctor has to pay for all this expensive technology somehow! That is rarely the case. Yes, it’s possible that another dentist may not have diagnosed the cavities, but that doesn’t mean they are not there! In any case, waiting to see is really not a recommended strategy, in that the idea is to preserve as much tooth structure as possible. The way these devices work is that they rank on a numerical scale the extent of the cavity. Sounds like your dentist is on the “cutting edge” in the use of this laser technology but nevertheless is being conservative in the areas where s/he feels the cavity is incipient, and recommending restoration where it’s gotten past that point.</p>
<p>If the patient is your family’s prospective college student, I strongly advise getting the work done right now, while the student is home. Eventually, those problems may progress into something that requires urgent treatment, and it’s really inconvenient to have to go to the dentist while away at college. In my experience (I have a son at college who has had dental problems in mid-semester), college health centers usually do not have a dentist on staff. Instead, they refer students to dentists in the community. Arranging appointments with a dentist in the community and traveling back and forth to those appointments can be difficult for students who do not have cars. It’s a lot easier to get it all dealt with at home.</p>
<p>Thanks for the replies. I do agree that our dentist is on the “cutting edge” and I do realize that the areas of concern would not have been detected with normal techniques. I need to get the specifics on each tooth in question to make a more informed decision. My nagging feeling about the whole deal though comes back to the patient and lack of prior cavities and my original question: is it likely that all 11 areas would continue to progress? If so why hasn’t there been a pattern of decay?</p>
<p>Yes, a cavity is likely to progress. The use of fluoride, great for hardening tooth enamel, can sometimes make it hard to detect cavities that “lie beneath.” There are many possible explanations for the presence of cavities in someone with no prior pattern, everything from the health and habits of the patient, to the ability to accurately diagnose, anatomical factors, and more. I’d suggest asking your dentist some of these questions for reassurance, but it sounds as if the professional opinion you are getting is that at least some of these are at the point where they need to be restored.</p>
<p>Ive been asked to comment, so here goes:</p>
<p>Youve already been given some good advice, so Ill just add a little more perspective.</p>
<p>First, I assume were talking about a young adult; my advice would be different for a parent. It is not unusual for me to see, along with the bad habits that cause the freshman 15, a formerly healthy mouth detiorate quickly. </p>
<p>Second, lets talk about the technology. There are two factors here: the accuracy of the device and the interpretation of the results. As far as accuracy, laser cavity scanning is fairly accurate, but there can be false positives. If the grooves of the tooth are not thoroughly cleaned out, the scanner can read debris as decay. In addition, the unit has to be calibrated for each patient and sometimes even the angle of the laser beam will change the reading. In interpretating the results, I believe in taking a holistic approach. In a cavity susceptible patient (one who seems to get new cavities every six months or a year), Id want to intervene on even the lower readings, because they will only get worse. On the other hand, I would let a cavity resistant patient slide and take new readings at their next visit. If the readings are the same, I would continue to monitor. If a cavity has not penetrated through the enamel, many times it will not worsen . I still have one originally identified in dental school 25 yrs ago which is unchanged. My oral hygiene is immaculate, but I have been known to indulge in sweets.</p>
<p>The best dentistry is always an intact tooth, but there are advantages to early intervention. With hard tissue lasers and air abrasion, the size of the filling can be kept extremely small, and many times no anesthetic is needed. Actually the most accurate way to use the scanner is to proceed cautiously and take new readings as you open up the tooth. If the cavity becomes visible, then aggressively clean it out.</p>
<p>Here is how I would recommend handling the OPs situation since there is undoubtedly some skepticism. If you trust the dentist, I would not bother to get a second opinion unless the second dentist also uses a laser cavity scanner. If the patient has excellent home care and reasonable nutrition, you can opt to wait until next visit and have new readings taken. A more prudent approach may be to ask the dentist to pick one or two (or three) of the worst ones and proceed as I described above, showing the patient the readings as they go or, better yet, showing a magnified photo of what they find (most dentists who have a laser probably also have intra-oral cameras). If they wind up being full blown cavities, definitely pursue the remaining ones. If they turn out to not or barely have penetrated the enamel, just monitor the rest.</p>
<p>This is exactly why i love this site so much. Whether it’s car insurance, a chili recipe, or dental advice needed, you can always count on intelligent people willing to share their expertise. Thanks for the detailed responses. </p>
<p>Audiophile: I do appreciate your conservative approach. When a visit starts out as a routine cleaning and leads to a potential $1700 treatment plan I definitely need a plan as you described.</p>
<p>bluejay, $1700 <em>does</em> sound like a substantial portion of the treatment plan calls for restorations. I originally interpreted you to be suggesting that only a few were slated for restoration while the rest were treatment planned for sealants. Audio’s suggestions are great advice in any case. Good luck!</p>