Overtreatment fear

[NervousUSA]

I'm a bit freaked out about my dentist I think they might be getting into over doing things. Overtreatment is my main dental fear though so wonder if I am just paranoid. I was hoping you could advise me over whether this is normal. Went to my dentist today and overheard them telling a kids parents that the kid needed to have fillings in their molars "deep grooves" to prevent decay. I have heard of sealant before but never decay preventative fillings. The parent was also told the kids teeth were clean and decay free. Is doing fillings to prevent decay in "deep grooves" normal? They also told the parent the kid needed baby teeth extracted because adult teeth could be seen coming in on an x-ray. I thought this sounded weird too, though maybe this could be normal in some situations?

I am having mild bone loss around my dental implant and was told by the hygienist that dental implants cause bone loss, it is a side effect from them, because of them being a foreign object in the body. I don't feel good about this because I was pressed hard to get an implant and told many times that I needed it to prevent bone loss from losing a tooth, but now the narrative seems to have changed to them causing bone loss. This isn't making sense to me.

Then the dentist started talking to me about me losing my other retained baby tooth and needing an implant for that because of seeing a a darker area near a filling on my x-ray, even though my tooth feels fine. I feel scared and confused about what is going on with these dental implants and wonder if people are told they prevent bone loss to sell the implant, but they actually cause bone loss. I was wondering if you knew if they prevent bone loss, or cause it, or what is going on?

Thanks for your time.

 

[Gordon]

Sounds a bit weird.
1) No, you don't do fillings to prevent decay. You do fissure sealants or if there is a small amount of decay in one part of the groove, you remove that, replace with composite and fissure seal the rest.
2) Removing baby teeth is occasionally necessary to allow adult teeth to erupt in the right place. It's not routine though
3) That's utter rubbish from the hygienist.
4) A darker area might imply some decay but I can't say without seeing x-rays. Baby teeth eventually "self destruct" later in life, nobody knows why, the root just spontaneously gets eaten away. You'll feel it getting loose when it starts to happen, a bit like when teeth were falling out when you were younger. It might be sensible to put some money aside for an implant in the future in case that happens.

 

[NervousUSA]

Thanks so much for the information, it really helps, I was worried I was just paranoid. Seems like there really is something odd going on there. I called them up and asked for my next appointment to be switched to another hygienist, I am afraid I am going to antagonize them, and cause offense and awkwardness, but I feel I can't continue with a hygienist who is just going to give me completely untrue medical information, seemingly for no reason. I was wondering if you would be willing to look at my x-ray for me? Here is the baby tooth in question. I lost another baby tooth in the past that I had, so I went through the loosening process you described with it, and that one I lost eventually became quite wobbly and got infected, this one in the x-ray feels very solid, not loose at all. The darker area is on the left side of my tooth in the picture below the filling. Thanks again for helping me.

 

[Gordon]

Personally I wouldn't touch that tooth. There is maybe some early decay below the fillings but it's not a big deal. Other dentists will have different opinions, there's no right and wrong with ones like this.

I am afraid I am going to antagonize them, and cause offense and awkwardness, but I feel I can't continue with a hygienist who is just going to give me completely untrue medical information, seemingly for no reason.

I doubt they'll be bothered TBH.

 

[NervousUSA]

Thanks so much Gordon, I really don't know what I would do without you. Was wondering if you could answer just one more question for me, if I got decay under my fillings that progressed, would there be any option other than extracting my tooth, like doing a new filling? Sorry to have so many questions and thanks for your time.

 

[Gordon]

Sorry for the slow reply, I had the grandkids staying this weekend. Getting on a computer was not a possibility
Depending on how bad the decay was, redoing the filling is an option. Baby teeth don't have a whole lot of substance between the pulp and the outside, so you can be a bit limited on how deep the filling can go, if that makes sense?

 

[NervousUSA]

I hope you had a fun weekend with your grandkids, no worries at all! Thanks so much for the advice! You have really helped me so much. I will definitely bring up the possibility of redoing the filling if the dentist says it has gotten any worse, then, he was going straight to "you will need an implant" but maybe we won't have to go there right away. Thanks for your explanation of baby teeth having less substance. Possibly part of the problem here is this tooth was IPRd by an orthodontist, both sides decayed within a year of that being done, back when I was a kid, so maybe there isn't much there at all, they have been refilled several times, don't know how much my dentist can tell though. BTW in case it is of interest to you, I looked up preventative fillings online and found a few dentists offering them on their websites, I only found one explicitly offering them for people without decay, this person:
https://clearsmiledentalstudio.com/why-does-my-dentist-want-to-give-me-preventative-fillings/ maybe it is some weird new trend. Here is a dentist who seems to be using the term preventative fillings to mean a situation where the person has a little decay:

What’s the Difference Between Dental Fillings, PRR & Sealants?

Dental sealants are plastic coatings professionally placed on the occlusal or chewing surface of your permanent back teeth in order to prevent tooth decay.

dentalexcellencegreenbay.com

Just wanted to share in case you might find it interesting. I think it seems very weird to get a filling with no decay. Thanks again so much for your help and time!

 

[Gordon]

Thanks for the kind words. Grandkids are great fun but exhausting

PRRs have been around a long time. But you start with there being some decay, if there is no decay then a straight fissure sealant is the correct treatment. If the decay is minor and just involving a small pit on the surface, you remove that then do the PRR basically a hybrid of a composite or glass ionomer filling and a sealant.

 

[NervousUSA]

@Gordon Thanks for making that clear, I am really grateful to you for helping me understand this situation. Because of your help, I know my dentist did overtreat someone, by doing them on someone without decay, so I will take precautions and not have any work done by him again without having a second opinion. I feel a lot better now I have a plan and am more clear on what is going on. Thanks again!