I have succeeded! Arrested caries! But now what???!!!

[Poppy1234]

I made a complaint in writing to my NHS dentist, over ignoring visible decay on the biting surface of a wisdom tooth for 5 years, which now has formed a small cavity, that I've been prattling on about on here for 2 weeks....! (I worry terribly about my teeth. My phobia is decay. I'm fine going to the dentist and with needles etc)

So....I get invited down to discuss my complaint with the head dentist.
Won't bore you with all that, but basically, it seems the decay HAS arrested, as it's gone hard, and is black now, and not brown.

So my question is "what now", as he seemed vague....??
Any thoughts on how it will fair in the future, for the rest of my life, with very good care?
I will continue to treat it aggressively for a long time yet, with the products I have, but I don't want to do this forever....

I've heard that once arrested, that area of decay will never start up again??(New decay can form though) But I've also heard arguments against this, and that it CAN start up again?? So which is it??

I find the idea of stopping decay exciting and of great interest to me.
But the idea of treating and watching this tooth for the rest of my life is boring!
At what point can I stop worrying about it, and just use a normal fluoride toothpaste twice a day, without faffing about with extra strong fluoride products and remineralising products??

If this will be a lifelong project, I'll get a filling, because it's too much hassle!!!

(Finding this place really interesting and informative! )

 

[decan]

Human enamel is made up of hydroxyapatite. Remineralized enamel (if you used fluoride) is made of fluorapatite, which is harder than hydroxyapatite. It is less soluble to acids produced by bacteria but decay is certainly still possible. IF the lesion has truly remineralized you can switch to brushing twice a day with regular toothpaste and with proper oral hygiene you should be fine.

 

[Poppy1234]

I've seen articles online saying once caries has been successfully arrested, that specific area of decay can never decay again. (Areas around it can of course)
My dentist disagrees.

Which is why I don't want a lifetime of treating this tooth.

You say once it's successfully remineralised then I can just brush twice a day, but my dentist appears to think it will always be vulnerable?

All dentists want to do is do fillings!
I have found dentists are mainly interested in fixing things that are damaged, rather than preventing the damage in the first place, and think I'm a fruit cake for daring to think outside the box, and wanting to try something other than fillings!!

Once you've drilled into a tooth, there's no going back.
You then have a lifetime of looking after a filling, and maybe having it drilled several times over your life.
Why would I want that if I can fix it myself?
But the variations in opinions are vast!
Dentists say cavities can never disappear. Plenty of people on the internet say this has happened to them.
Of course they could be lying! So that's why I'm seeing for myself!

 

[decan]

Once the pH of your mouth drops below 5.5 the bacteria start secreting acids that dissolve enamel. This pH needs to be lower in order to dissolve fluoridated enamel. Remineralized enamel can certainly decay again, but it will be tougher to do so. Never is a strong word.

Also, brushing twice a day is important but brushing appropriately for the right amount of time is even more important. Many people think they brush for 2-3 minutes but they really brush for 30-45 seconds.

 

[Poppy1234]

Once the pH of your mouth drops below 5.5 the bacteria start secreting acids that dissolve enamel. This pH needs to be lower in order to dissolve fluoridated enamel. Remineralized enamel can certainly decay again, but it will be tougher to do so. Never is a strong word.

Also, brushing twice a day is important but brushing appropriately for the right amount of time is even more important. Many people think they brush for 2-3 minutes but they really brush for 30-45 seconds.

Thanks! Ever since I've started using toothpaste I've been timing myself to make sure I brush for 3 mins!

My main problem now will be keeping this small cavity free of plaque and bacteria and food.
The caries has arrested (hopefully. No-one can be totally sure) but there's still a small vulnerable cavity.
I need to keep this very clean, or decay may start again. Or new decay will form.

Though to me, the cavity looks no deeper than a normal fissure, so I hope it won't be any more vulnerable...

I have been gently scraping the cavity with a dental probe each night, to remove plaque.
Does anyone know if this is ok?
I'm woriried I may be scraping away the newly forming calcium that is (hopefully) remineralising the hole!!
As fast as "Restore" with NovaMin is rebuilding the hole, I could be scraping it away! But I feel I need to keep the hole clean.

It's quite exciting! I'm learning loads.
I have a much deeper understanding of decay now.

I guess I really should get a filling, as the hole will always be vulnerable, but maybe it won't always be a hole........
Dentists don't believe cavities can heal over, but there are plenty of testimonials online that say products like NovaMin HAVE filled in small cavities over time, so I'll give it a bash.

Unless my next x-ray says it's got worse, then I'll get a filling.
Another suspect area has been found too, so I now have 2 teeth with early decay.
I'm mortified, as I have always cleaned my teeth after eating and have never eaten sweet things...............

 

[Poppy1234]

The more I read and research online, the more I'm reading about people whose small cavities (before it reaches the dentine) have disappeared by using the right products and good diet.
But maybe I'm just looking for what I want to hear!

I guess a small cavity in a fissure on a biting surface will always be a bit vulnerable, even if the decay has totally arrested.
But all molars and wisdom teeth have pits and fissures that are vulnerable to getting plaque and bacteria and food stuck in them.
Can't see why my wee hole will be that much more vulnerable if I keep it super clean.

Maybe in a year using "Restore" (for remineralising enamel) it will be getting smaller....A lot of people on the internet swear the NovaMin in this shrinks cavities.
It certainly makes your teeth feel instantly smoother, like it's doing good things to the enamel.

I just can't shake off this rage with my dentist for allowing it to form a hole in the first place. He knew I had a phobia of decay.
Maybe it's because I lost someone because their doctor didn't diagnose cancer in time. They just ignored it, until it was too late.
I feel such rage at a dentist that can't spot decay. Especially as I've found out he's missed another area of decay, that left unchecked, would result in another cavity.
This time a visible filling between incisor and pre-molar would be needed, so I'd have to pay privately for a white filling, as a silver would show.

What is it with dentists that can't spot decay?
That's THREE NHS dentists in total that missed this new problem area.

 

[decan]

Have you ever considered sealants?

 

[smithers]

Have you ever considered sealants?

don't start that one again!

 

[brit]

don't start that one again!

There's a separate thread already!

 

[Poppy1234]

don't start that one again!

Hehehe...

I've found a place that does seals for just £12. On teeth with no decay.
But you need to pay £49 for a check-up, when I don't need one!
Mine will do them for £15 for the first 8.

I'm not convinced you can put a seal over a cavity though, and for it to last. Keep hearing too many things that suggest this is a bad idea.
My private dentist said no way, and wants to charge £67 for just a silver filling.
But this is free for me on the NHS if I decide to go for a filling in a years time.

 

[decan]

Sealants work. They have been shown to arrest small cavitated lesions.

 

[Poppy1234]

Sealants work. They have been shown to arrest small cavitated lesions.

So you just put one on the top of decay?

I heard that would force the underlying decay deeper into the dentine and further deeper decay in the future.
I also heard it would cut off the supply to the decay so it arrests.
So opposite opinions out there!!

But I can't find a dentist that will do this anyway.
One wanted to drill and do a seal, but the whole reason I'm trying to arrest and remineralise is to avoid the trauma to the tooth of ANY drilling.
If someone was to drill the tooth, I'd get a silver filling.
I don't need the hassle of worrying about a seal over a drilled out cavity.

My decay has arrested. But there is still a hole.
Problem now is preventing any baddies getting into the small hole in the future and making fresh decay.
Hoping the NovaMin will heal it over in time. Fingers crossed!

 

[decan]

If decay is limited to enamel a sealant over the area can arrest the decay process. If you find research that says otherwise, I'd be interested in reading it. The "drill and seal" you're talking about is called a round bur sealant. They can open up the pits and fissure system a little (not much) to either remove some decay and/or increase the surface area for the sealant to grab onto. If your decay is in fact arrested a sealant over the area will cover the hole you're talking about.

 

[Poppy1234]

If decay is limited to enamel a sealant over the area can arrest the decay process. If you find research that says otherwise, I'd be interested in reading it. The "drill and seal" you're talking about is called a round bur sealant. They can open up the pits and fissure system a little (not much) to either remove some decay and/or increase the surface area for the sealant to grab onto. If your decay is in fact arrested a sealant over the area will cover the hole you're talking about.

My dentist simply wouldn't just put a seal over the top, even though I'm pretty sure decay has arrested and is only in enamel.
He said it would force decay further down into dentine.
Nor will he drill and place a sealant, as he says this doesn't work, and you can't put a seal over a drilled cavity.

I'd really like a seal on it if possible. The hole seems very vulnerable!
But no-one will do it. I guess because they aren't 100% sure it's arrested.

Maybe in a year they will be convinced, and will place a seal on with no drilling.

I know I've read something about this not being a good idea, but I don't know if it was actual proved research I read, or something I just read online that a dentist mentioned.
I've read up a lot over the past 2 weeks, so can't recall who said what!

 

[Poppy1234]

Asked again. Nope. He refuses to put a fissure seal over arrested caries.
Clearly it makes way more sense to leave me with a vulnerable small hole for life, than seal it....not...

I see no reason to drill a tooth with arrested caries contained within the enamel, but dentists appear to be obsessed with drilling.

Maybe I could fill it myself! Just to protect it for a year, until he finally accepts 100% it's arrested. Then maybe I'll get my seal!

This might be a temp repair, but I've heard they can actually last ages!
There's enough for 10 fillings here, so even if each one lasted just a month, I'd have 10 months of protecting the hole, for just a few quid....

[broken link removed]

 

[Gordon]

Noooooo! That's a temporary dressing material, at best it'll last a few days.

 

[Poppy1234]

Noooooo! That's a temporary dressing material, at best it'll last a few days.

LOL!
Thought so, but some people swear they last for ages!!

Give me my fissure seal!! (Beats fists on table and sulks!!)

I even offered to sign a disclaimer to say I accept responsibility if decay caries on underneath. I'd check after 6 months. Any further decay and I'd get a filling fast.

 

[Poppy1234]

Hmmmm....Asked my new private dentist about fissure seals on all my other teeth. No problem. Only £12 per tooth....

But....He had to review my x-rays to determine which teeth would be suitable, and he NOW reckons the decay has just entered the very surface of the dentine on the wisdom tooth....
So I guess that's the end of my experiment then...
Can't mess about with decay that's progressing.
Seemed to have arrested in the enamel too.....BUMMER....