One molar, two cavities, big decay?

[MolarsinMilan]

Hello everyone - short time lurker, first time anxious poster.

I'm a Brit in Milan, and yes, it had been a while since I visited the dentist (about 9 years).

I finally went, and in one of my molars (47) there's a cavity on the biting surface. A hole in a pit, narrow but 2mm deep, so yay for dentin involvement. The walls and bottom feel hard under the explorer, so I thought maybe there's hope my tooth isn't a hollow shell or that the decay extends way deep near the pulp (I have no spontaneous pain, pressure pain or heat/cold sensitivity). I have an appointment on the 17th for it, which I have been mentally preparing for by practicing holding my mouth open, keeping my tongue out of the way and getting used to dental dams (if they use one).

HOWEVER...

...today while cleaning I noticed a tiny hole on the buccal surface of the same tooth (you know that pesky groove?). Well, it's a small hole, but it looks like it's through the enamel and there is the tiniest speck of black at the end. I messaged the dental studio about this so there it be a surprise during my filling (and also a cost update).

So, A) crap, that undoubtedly makes two fillings, but B) does this mean everything underneath is ruined?

I read online, huge mistake I know, that when the decay under a buccal cavity gets large, other cavities will present as the enamel becomes unsupported (or something to that effect). i.e. I fear one fed the other and that my tooth is just gonna shatter under 180,000 rpm of drilling.

Is it possible for two independent areas of caries to develop at the same time? That is, could the buccal hole and the occlusal hole be independent of each other?

Some wonderfully bad photos attached which I know aren't any basis for diagnosis.

 

[MolarsinMilan]

P.S.

As I'm sure it'll be asked: no, I haven't had x-rays. During my first appointment, a young dentist saw the occlusal hole and said it's small, let's wait. I asked, "should we do x-rays?", "if you aren't presenting with pain, I don't think it's necessary. Let schedule you for a cleaning."

Anyway, I knew it was deeper than he thought, so I came back in for an urgent check, the director of the studio was in. He looked and went, "yep, that's deep, let's get that filled." He checked around again for more cavities... didn't clock the buccal one on the same tooth, but he seemed pressed for time. We all make mistakes.

Again, I said, "Facciamo un x-ray? / Are we doing an x-ray?" and the director said it seemed straight forward enough without one.

Maybe now I'll get a reply to my email to come in for one and discover every tooth is just a barely supported facade of decay. Hopefully my cleaning, lack of sugar, and obsessive chewing of Xylitol gum has spared the rest of my teeth.

 

[Gordon]

Think you're worrying over nothing. It's not uncommon for cavities from the biting surface to continue through the fissure into the buccal side of the tooth, but it's not likely to be a massive hole. Certainly doesn't look that bad in the photos.

 

[MolarsinMilan]

Think you're worrying over nothing. It's not uncommon for cavities from the biting surface to continue through the fissure into the buccal side of the tooth, but it's not likely to be a massive hole. Certainly doesn't look that bad in the photos.

Hi Gordon, thank you for the reply. If anything is certain, it's that I'm over thinking things. Heck, I'm doing a dry run today in preparation for next Monday (which is either immersion therapy or obsessiveness).

The head of the studio certainly wasn't alarmed beyond, "it's simple, let's fill that hole". So, I'll go forward with that and your post haha

Have a good week

 

[MolarsinMilan]

Think you're worrying over nothing. It's not uncommon for cavities from the biting surface to continue through the fissure into the buccal side of the tooth, but it's not likely to be a massive hole. Certainly doesn't look that bad in the photos.

I had my appointment today! I was so, so worried. I havered outside the front door of the studio for five minutes. Eventually struck up the courage to go in. The nurse took me in gently, said let's just sit in the chair as a first step.

Then the amazing dentist came through, and just sort of blindsided me with efficiency. Within 5 mins he had drilled and filled both holes without having to use the anaesthetic.

Part of me wanted to beat myself for worrying for two straight weeks, but a way bigger part is immensely proud I went in and did it. Scheduled a cleaning next and have my six-month check-up booked in. On Cloud 9.

 

[Gordon]

Well done and thank you for updating on how you got on. It's good to hear about success stories.