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Old 05-07-2005, 11:10 AM   #1
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Why am I getting so many cavities?

I'm 18 years old. *Up until last year, I'd always been told I had great teeth--then I went to a new dentist who found 14 cavities at my first visit (as well as 4 and 5mm periodontal pockets and receeding gums). This new place has a lot of fancy equipment and is much more high-tech than my old dentist, so I'm inclined to trust them.

I've been going every three months for a cleaning, and every time, they've found new cavities. *I can even see little black lines forming in my molars, and I think I see some on the back side of my front teeth.

I brush two or three times a day and floss twice a day--always. *I don't eat refined sugar, drink soda, eat candy, etc. *I do eat a LOT of fruit though. *If I ever snack between meals it's on something like vegetables.

I can't figure out why my teeth are in such bad shape, especially at my age. *Most of my family has good teeth. *No matter how well I take care of my teeth, it seems like they just keep getting worse and more cavities keep forming.

Any ideas on why this might be happening? *Or what I can do to prevent the cavities?

 
Old 05-07-2005, 01:20 PM   #2
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Re: Why am I getting so many cavities?

Hi-Tech is good for the dentist, but as far as the patient is concerned.. I wonder... I had a hi-tech computerized dentist, but now I have an old dentist (I hope he doesn't retire)... Working with teeth is as much as an art as it is a science and experience counts for a lot... Anyway, regarding your cavity problem, if you eat a lot of cereals, they are mostly carbs and might stick to your teeth and be harder to clean off... This is one wild guess... Don't give up looking for an answer.. I had/have a similar problem and one change (out of many) that I'm wondering about is the hot vegan cereal cups I switched to eating... So, I'm suspicious...

 
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Old 05-07-2005, 01:23 PM   #3
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Re: Why am I getting so many cavities?

Hey Veggie Girl
I hate to be cynical, but if you have always had good checkups with the dentist, up until the new one. You may want to get a second opinion before proceeding with all the (expensive) dental work. All the new fancy equipment doesn't mean much. Someone of your age to have problems with deep pockets (and you have good dental hygiene) is a wee bit surprising. I'd check out a second opinion, if possible. So, unless you have some vitamin deficeincy from your diet, or your teeth are just naturally "soft", or a medication has affected your teeth...it doesn't seem possible to have cavities forming so quickly. When I was your age I had a friend, whose dentist told her she had 32 cavities!!! I know this is posssible, but usually with people who do not take care of their teeth. My last dentist always seemed to find some new thing to do to me, too. And he had all the fancy equipment too. Well $3,000.oo later I stopped going. I'm going to a differnet one now and all I need is the root planing/scaling thing done, and it's been 6 years since I last went & I am 50 yrs old. I smoke, don't have half the good dental hygiene habits you do, and I should be having the problems you are having instead. All I am saying is that it wouldn't hurt to get a different opinion. If you are having all these problems for sure, than a second opinion wouldn't hurt.

 
Old 05-07-2005, 02:31 PM   #4
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Re: Why am I getting so many cavities?

The nature of diagnostic dentistry is subjective. If you went to 10 different dentists they would most likely give you 10 different opinions. Much is based on education, experience, patient individuality, clinical/radiographic evidence, and various diagnostic tools/technology.
I have seen new patients enter the practice with tons of decay, why? Who knows? Maybe the previous dentist was more conservative at caries diagnosis, maybe he "felt bad" and didn't want to over treatment plan, maybe x-rays were not taken, maybe a full periodontal probing was not assertained and pocketing was never found. It is frustrating for both the new dentist and the patient. But it doesn't hurt to get a second opinion or at the very least talk to the dentist, explain your circumstances and have him show you what he is seeing.
Some dentists are much more "proactive" at treating small suspicious lesions, while others are more conservative and have a watch and see type of philosophy.
Sometimes baby cavities can form (incipient lesions)--some will fill, while others will watch encouraging diet control, good hygiene and home fluoride in hopes it will remineralize.
As a consumer and patient it is your responsibility to be as knowledgable as possible about what is going on in your body and know what your philosophy is and what your practioners philosphy is. Then together you can collaborate to get you to optimum oral health.

As for your question regarding decay prevention. Good oral hygiene--brushing with an electric toothbrush, prescription home fluoride and flossing. Diet control--reduce amounts of carbs, especially foods that stick to the teeth (dried fruit, crackers, chips, cookies, candy) and soda/sugared coffees.
Dry mouth especially from meds can also increase plaque and reduce salivary flow thus clearance of foods and natural buffers/enzymes/antibodies that neutralize bacteria.
There is no such thing as "soft" teeth. Cavities are all about bacteria, if it were not there you would not get decay.

 
Old 05-11-2005, 09:49 AM   #5
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Re: Why am I getting so many cavities?

I speak from experience! Please don't assume that because he has a fancy office and a fancy practice that he is a superior dentist. Remember one thing, he has to pay for all that flash! And it isn't out of his pocket, it's out of yours. A good dentist, and I was lucky to finally find one, has an "old time" type practice. He doesn't schedule 20 patients in a day and he takes as much time with you as you need. Granted, his office is smaller and not near as fancy, but he has helped me through some extremely major problems created by the first one. Again, I stress, PLEASE PLEASE don't assume he's good based on the "trappings" in his office.

 
Old 05-11-2005, 10:43 AM   #6
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Re: Why am I getting so many cavities?

With the advent of fluoride, the number of cavities in young people has decreased dramatically. Fluoride hardens the enamel making it more resistant to the effects of the acids produced by bacteria. An unfortunate side effect of this increased enamel hardness is that decay is more difficult to detect. Decay will progress along the path of least resistance. Once the decay has penetrated the enamel, it will continue to worsen in the dentin - the tooth structure under the enamel. The point where the decay penetrates the enamel may be too small to get a stick with the dental pick - the traditional method of detecting cavities. Yet the decay can get quite deep. The increased hardmess of the enamel makes it more difficult to see the decay and its extent on x-rays. As a result, decay is often difficult to detect and when seen on x-rays, it is most often much deeper that it would appear.

A problem with someone saying that they have good oral hygiens is that sometimes they do and sometimes they don't. Even when they think they're doing a good job. If you want to know just how good a job you really are doing, use disclosing tablets AFTER you do your normal routine. If you see red on any tooth surface, then you're not doing as good of a job as you thought you were.

There's never anything wrong with getting a second or third opinion. Or as many opinions as you need to feel comfortable with the treatment you receive. It's your body and you need to feel good about what is being done and who is doing it. As for a high tech vs low tech office, it's all in the dentist himself as to how good he really is. High tech is nice because these offices employ state-of-the-art diagnostic tools and techniques to increase the quality of care you receive. You can still receive quality care from a low-tech office. Most people will never know if their dentist is good, bad or mediocre. People tend to use: "He spends time with me and is nice.", or "He didn't hurt at all.", or "His fees were quite reasonable." as the criteria of who is good. Unfortunately, these attributes usually have little to do with the quality care you receive.

I would prefer to have someone who keeps up with the latest techniques and materials. Has an interest in what he is doing. Takes continuing education courses regularly. Is not afraid to refer to a specialist. Has been in practice for at least five years. And listens to what you have to say.

 
Old 05-11-2005, 01:45 PM   #7
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Re: Why am I getting so many cavities?

So true, Camchase, I couldn't agree with you more. Fancy facilities don't necessarily equal quality care and I speak it with experiences too. After moving to another state, I had one dentist after examination said I had 6 cavities, and I only had had seen and been taken care of by another dentist less than a year prior. This new dentist was also recommending other cosmetic works and I didn't feel comfortable about. So I decided to seek a 2nd opinion and was told I only had a small loose filling on one tooth. I also have seen a so called cosmetic dentist with aggressive advertisement and his waiting room has a giant screen TV constantly playing before and after photos of cosmetic dental procedures. He showed a lot of cases to me of patients with numerous crowns and vaneer works, whom in fact I felt that a lot of them looked better or more natural before the treatments. I can never understand why some people would going into dental offices with perfectly healthy, natural looking teeth and put on crowns and vaneers like having pedicures. Do they realize that the health of their teeth are being jeopardized and could have serious problems like pain, root canals, fracture etc... down the road? I think a lot of patients are not being adaquately informed on the risks of these elective procedures. Money is of course the driving force behind it and we are talking of lots and lots of money.

 
Old 05-11-2005, 02:31 PM   #8
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Re: Why am I getting so many cavities?

The reasons people have for getting cosmetic veneers and crowns are the same reasons they have for breast augmentation, liposuction, face lifts, brow lifts, blephoplasty and numerous other cosmetic surgeries. All of which carry a certain degree of risk and irreversibility. It is the quest for youth, the Hollywood look and simply looking better. Many people don't have a desire to look better. They need to find dentists who do not focus their practice on cosmetics. For those who do want to look better, they should seek out dentists who focus on cosmetics. Of course this does not have much to do with the high-tech office, except that most dentists who focus on cosmetics usually have the latest equipment. A high-tech office is simply a quest to improve the quality of care delivered.

I find it interesting that people who get second opinions who are told that instead of four, five or six cavities, they have only one always think that the dentist who says they need less treatment is right and the better one. How does the patient know that the dentist who says only one cavity exists isn't missing three, four or five other cavities? A year later when the patient needs a root canal because one of the other undiagnosed cavities got worse, he can't understand it. Don't make the assumption that the dentist who treatment plans less is right or the better one. The opposite might very well be true. If two dentists are that far apart in diagnosis, a third opinion is warranted.

Last edited by Cinemagic; 05-11-2005 at 02:35 PM.

 
Old 05-11-2005, 04:19 PM   #9
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Re: Why am I getting so many cavities?

Cinemagic: I speak from experience. I was diagnosed with periodontal disease by a "hi-tech" dentist and told I needed $1200 worth of treatment for it. After a 2nd and 3rd (periodontist) opinion I learned I did NOT have periodontal disease, did NOT have generalized 4-5mm pocketing and did NOT need the expensive treatment; only regular cleanings every 6 months. I have to wonder how many of the $1200 treatments he has to sell to keep his fancy office operating; needed or not! You sound like a member of the dental community and as such you should be outraged when you hear of such things going on. It should never be "just accepted" but fought vigorously, especially from those inside the dental community who bear a slight black eye from this type of fraud. It is inexcusable and unconscionable.

 
Old 05-11-2005, 05:53 PM   #10
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Re: Why am I getting so many cavities?

Absolutely. Unnecessary treatment is unethical and should not be tolerated. I can tell you that in my state, unethical treatment is dealt with whenever possible. My problem with this thread is that some people tend to equate dental practices using the latest equipment and materials (high-tech) with unnecessary treatment and "over-sell". Nothing could be further from the truth. Fortunately the percentage of unethical dentists is very low, but you will find them in high-tech, low-tech and in-between type offices. My point is simply that it is the individual dentist that is ethical or not and that IMO the majority of dentists employing the latest equipment and materials are ethical.

 
Old 05-11-2005, 05:56 PM   #11
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Re: Why am I getting so many cavities?

camchase:
Treatment planning new patients can be a little tricky. Therefore, some dentists will pick one or two things to do first having in mind that more needs to be done in the future. After the patient is more established in the practice, they will then incorporate more work. Others will just hit the patient with everything they see at the first visit. The difference between the two is not that one sees more than the other, it is just a different way of delivering treatment and getting it to be accepted.

Cinemagic: I would prefer to have someone who keeps up with the latest techniques and materials. Has an interest in what he is doing. Takes continuing education courses regularly. Is not afraid to refer to a specialist. Has been in practice for at least five years. And listens to what you have to say.--ditto

 
Old 05-11-2005, 07:10 PM   #12
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Re: Why am I getting so many cavities?

No offense WaRDH, but my point was with the unethical & fraudulent diagnosis of a condition that does not exist in a patient, simply to keep the "brass and glass" office afloat. People in the dental community wonder why people are so cynical about the dental practice and that is why. It takes one "bad apple" to ruin the reputations of a world of good dentists. And no one can blame the patient who has had this happen to them. How do they trust again? How do they believe the next dentist or doctor who tells them they have this or that and they need this treatment or that treatment? Again, you cannot blame the patient. And when you talk to another person in the same profession all you get is "uh, well, I don't know about that" or they don't say anything at all! Shame on them, as well, for providing a place for this to happen again and again. Thank goodness I have 2nd and 3rd opinion dentists who are willing to stand up and say that it is fraudulent. But I feel for the person who cannot find that ethical dentist out there that won't tolerate another's fraud.

 
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