I recently went to my dentist and she began picking away at my teeth as usual looking for cavities. Unfortunately for me her search was successful a few times as she would almost cheefully state "you've got a cavity here", or "there's decay in this one." She was doing a lot of picking even on the teeth that were okay. Some of those she labled "watch" areas. All this was done before x-rays. What I was wondering is what's with all the picking? What determines what's a cavity, a watch, or whatever.
Ahhh, the fine art of caries detection! Actually several different techniques can be use for detecting decay. I prefer to use the Mark1 eyeball for "virgin" teeth after blowing them dry. I like to reserve the explorer for probing around fillings, crowns, and such. The probe can be placed into suspicious areas to determine "stickiness". The sticking of the probe indicates softening enamel (ie decay). Sometimes it can be difficult to determine if decay is present (ask 5 different dentists and you may get 5 different answers). These teeth are usually labeled "watch" and re-evaluated at future appointments for any change. Unfortunately detection of decay is more of an art rather than science and can be quite difficult at times... X-rays are not good at detecting decay from the biting surface of the tooth, they're best for detecting decay in between teeth in areas that can't be directly visualized.
[This message has been edited by Ship (edited 07-01-2001).]
Oh I just love the term "watch". I secretly call this "watch it get bigger". Basically if you don't change your oral hygiene habits these "watches" will probably become a cavity before too long. When a "watch" is placed for a surface inbetween the teeth, we "watch" it get big enough to fill. Our office uses this wonderful laser cavity detector. It's really neat, it can detect the smallest amount of decay starting on the chewing surfaces. I'm afraid to have it used on me, as I'm sure that some decay could be found, I just don't want to hear the bad news. Anyways a small filling is much better than a large filling. So if you have decay, get if fixed, and keep up on your dental appointments so that the dentist can keep watching those teeth, and recommend fillings as needed. Good Luck!
Decay is not an inevitable process. Shaelle mentioned the "watch it get bigger" philosophy in her reply. Although it sounds pretty cynical I feel the same way sometimes. The decay in between teeth can be REVERSED with proper oral hygiene, regular professional cleanings, and flouride use but both she and I know that most patients will not make the effort. As a result, the decay gets larger and becomes a true cavity (hole in tooth) in a year or two. I have seen plenty of patients with small spots of decay that have been there for years and years with no change so hope is out there. I factor things like age of patient and oral hygiene in my decision to fill now or later. If the patient is older then its quite likely that the decay has been there a long time with no change. I use the "watch" more often for determining wether to replace exsisting fillings or not. I used to be fairly agressive but recent studies show that the silver amalgam fillings hold up really well and are ok even if a little broken down around the edges. These are the typical "watches" that I examine carefully from exam to exam.