Conflicting Advice (Decay) - X-rays included

[Bert2000]

Hello,

I'd be extremely grateful for any guidance.

I had these x-rays taken at the beginning of December just prior to having my fillings replaced. The dentist, having considered the x-rays, asked if I have a sugary diet. I think because of something she observed along the tooth surfaces. I explained that I do not, but have previously not been the best at flossing/brushing twice per day. I asked if the problem she could see was reversible and she said it could be in theory.

Over the past 2 months since that conversation, I have brushed twice per day with a fluoride tooth paste, flossed every day, reduced sugary foods dramatically (basically only fruit), and have recently started using a fluoride mouth wash.

I went to a new dentist for a check-up last week, so 2 months after the previous visit. She takes a new x-ray as I explained there may be a delay in getting the attached ones sent to me. Presumably there would be little difference compared to those taken 2 months earlier. She examines the x-rays and tells me that she can see 1-2mm of decay along the surfaces and that it would be negligent for her to leave it. She says I need 5 fillings, costing around £700. This comes as a shock to me.

I go for a second opinion at another dentist, not telling him about the outcome of my last appointment. He said, during the examination, that he could not see any signs of decay. Several days later, after he has viewed a copy of the x-rays taken, he says he cannot see any problems.

Who is right!?

 

[Bert2000]

View attachment 1008
View attachment 1009

I should add that I have a history of sleep bruxism (well, around 7 years anyway - I am now 32), which has gone some way to flattening my back teeth and probably weakening them. I have consistently used a nightguard to protect them for the past 3 months.

What I am mainly interested in is: whatever problem is observable on the x-rays (if any) is it possible for me to halt its progress, or even reverse it, if I continue my twice a day brushing, flossing everyday, fluoride mouthwash after eating meals, avoiding sugars, and taking a high potency cod liver oil (vitamins k and D), plus mouthguard every night? If I go with this policy, and not get any fillings, am I likely to be in a worse situation in 6 months time?

Any thoughts would be appreciated.

Robert

 

[comfortdentist]

Your image is highly compressed and therefore has lost much of the diagnostic value. Your image is about 50kb while my digital image is about 2 Mb in size.
Your image does suggest that you are getting interproximal caries that needs attention.

 

[jen2605]

I'm not a great expert, but it does look on the x-rays that there are a few places in between the teeth that it looks like the decay has gone through the enamel layer into the dentine, and that means that you need fillings. Once the decay is into the dentine, you can't reverse it, and it's likely to just progress further.

 

[sillyandscared]

I'm 21 and I'm pretty much losing all of my 2nd molars to bruxism, at 21 I'm on 2mg valium twice a day and use a night guard. I'm going to have my second, second molar extracted next week. It's sad. Are you in pain, are the areas in question becoming infected? Are there visible cavities? My back teeth are shot, was never properly seen as a child, and as soon as I became an adult. There was a 6000 dollar bill for all the crowns/root canals I needed only in the "Grinding" area. The rest of my teeth are healthy. Not being able to afford that and not wanting to go through ANYMORE infections. I opted to just say bbye to all my second molars. I've had all my wisdom teeth out. And I'm going to start repair on the rest of my teeth once the rest of the seconds are out. I would get one more opinion. Any damage/cavity is a bad one. You can do one at a time if it's not causing you pain. Cheaper.

 

[rob wain]

Hi
The images aren't great but there are several cavities, some still within enamel, others are apparently just into dentine
remember that the decay is worse in the tooth than it appears on the xray
in theory enamel dentine can be stopped or reversed. dentine decay can be arrested in its early stages but not once it is more advanced.
reversing decay isnt always predictable so different dentists may have a different approach.
In my view a preventive approach is appropriate for certainly some of those areas. Others are borderline and the decision would depend upon other factors only really determined with a clinical examination.
In a nut shell - I wouldn't go with fillings yet but prevention needs to be proactive with further rasdiographs to monitor.

 

[Bert2000]

Hi
The images aren't great but there are several cavities, some still within enamel, others are apparently just into dentine
remember that the decay is worse in the tooth than it appears on the xray
in theory enamel dentine can be stopped or reversed. dentine decay can be arrested in its early stages but not once it is more advanced.
reversing decay isnt always predictable so different dentists may have a different approach.
In my view a preventive approach is appropriate for certainly some of those areas. Others are borderline and the decision would depend upon other factors only really determined with a clinical examination.
In a nut shell - I wouldn't go with fillings yet but prevention needs to be proactive with further rasdiographs to monitor.

Thanks Rob, appreciated.