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When Is A Filling Needed?

N

NewlyAnxious

Junior member
Joined
Dec 18, 2018
Messages
2
Location
USA
I used to have dental anxiety, but found a great dentist and went for years with no problems. I even looked forward to going. That dentist retired and a new one took over. Ever since then I've had cavities and have once again developed dental anxiety. It's being made worse because I'm starting to doubt if all of the fillings I've had are necessary. I noticed a note from my last appointment that said I had a cavity and two suspicious spots, but I received three fillings then. Is it necessary to fill spots? I put off my cleaning all year and just recently went and have six cavities. This time I'm going to get a second opinion so I feel more confident in what treatment is needed. My dentist office was gracious about sending recent xrays to the new dentist. I really like the office (front desk, hygienists, etc.) so I don't really want to switch offices but am concerned about the dentist. If the new dentist agrees with the treatment plan, I will feel a lot better. I've also been thinking about asking if I can pick up a copy of my dental appointment notes, and if the office can send last year's xrays to the new office. I'd like to ask the new dentist if filling the suspicious spots was necessary, but wasn't sure if they would discuss it since it is after the fact. Knowing another dentist agrees with my current and past treatment plans would give me confidence in my dentist and greatly lessen my dental anxiety, but I'm not sure it is appropriate to ask. I also am worried about annoying my current office for no reason, especially if I stay with them.

I know when a filling is necessary can be subjective, but was wondering if anyone had any experience with getting a second opinion. Is it okay to ask the new dentist about past work? Also, if there are any dentists here, would you discuss this with a patient coming to you for a second opinion? Could you give an answer with only the past xrays?

I'm really nervous about going to this new dentist and want to make the most of it. I'd appreciate any insight anyone can offer.
 
grumpybear

grumpybear

Well-known member
Joined
Aug 30, 2018
Messages
115
I've only ever had 1 filling in my life, so I can't really comment on when a filling is necessary. But on the topic of 2nd opinions, I've sought one before, that was for that 1 filling (which was deep) that I had and my tooth was starting to hurt and won't settle. My dentist who did the filling said I needed a root canal, but my orthodontist at that time told me to wait it out. I decided to get a 2nd opinion with another dentist outside who told me to wait and see. My tooth eventually did settle. I told the 2nd dentist up front that I was here for a 2nd opinion on the recommendation of a root canal and also provided the findings of my own dentist to him. The 2nd dentist did his own investigations and tests and then provided his own recommendations to me.

Personally, I would say if you have been taking care of your teeth properly and have been going for regular check ups where you were all clear, I would be suspicious if a new dentist suddenly tells me I need 6 cavities. I would get a 2nd opinion on that 6 cavities, but not on the ones already filled because it is already after the fact.
 
letsconnect

letsconnect

Administrator
Staff member
Joined
Jan 1, 2005
Messages
5,668
Hi NewlyAnxious :welcome:,

I'm not a dentist but will try to answer your questions to the best of my knowledge:


I noticed a note from my last appointment that said I had a cavity and two suspicious spots, but I received three fillings then. Is it necessary to fill spots?

If "spots" refers to incipient lesions (i.e. early decay that hasn't progressed beyond the enamel and into the dentine portion of the tooth),then the usual course of action nowadays is to try to get them to remineralise (you can find tips for stopping tooth decay from getting worse on this page: How to prevent tooth decay ).

However, some dentists (and this seems to be much more prevalent in the US) like to treat very aggressively, either because of monetary incentives/pressures (esp. when working for dental chains) or because they have been taught that problems will escalate quickly if they don't intervene. The latter is an even bigger problem with new patients, because they don't know their dental history and then can get very jumpy instead of adopting a watch and wait approach.


I put off my cleaning all year and just recently went and have six cavities. This time I'm going to get a second opinion so I feel more confident in what treatment is needed.

A second opinion sounds like a really good idea! We've put together some ideas for finding a dentist on this page: Finding the Right Dentist


I'd like to ask the new dentist if filling the suspicious spots was necessary, but wasn't sure if they would discuss it since it is after the fact. Knowing another dentist agrees with my current and past treatment plans would give me confidence in my dentist and greatly lessen my dental anxiety, but I'm not sure it is appropriate to ask.

Here's my take on this: there's no real point in asking, for two reasons. Firstly, as you correctly guessed, it's usually impossible to tell what was there after the fact (x-rays are two-dimensional images so not everything can always be correctly visualised - so even having the "before" x-rays won't necessarily allow for a definitive judgement). Secondly, it is considered very bad form (and very unprofessional) among dentists to look down on or be critical of another dentist's work in front of a patient (there can be exceptions to this rule, for example stunningly bad dental work that is impacting on a patient's quality of life and should be reported to the regulators in order to protect other patients - but this would not apply here).

In short, you may not want to ask the new dentist about past work (unless you're currently experiencing problems with it of course). It just puts them into a slightly awkward position (but one they encounter on a regular basis, so they'll be well used to dealing with it).

Keeping my fingers crossed for you that the new dentist is everything you are hoping for and more (and if you're not convinced, do get a third opinion) :thumbsup:
 
Enarete

Enarete

Super Moderator
Staff member
Joined
Sep 18, 2017
Messages
3,234
Dear NewlyAnxious,

sorry to read that your old dentist retired and that you do not feel too confident with your new one.. reading your post it sounds like you 'just' would like to get reassurance about the necessity of the work your dentist did and like you would like to avoid changing dentists. I might be wrong, but I am not sure if just hearing 'yes, the treatment was right' or 'no, the treatment wasn't right' would be enough to ease your anxiety. Dental treatment has a lot to do with trust and feeling of being in good hands and doubting the diagnosis is, in my experience, something that often comes from a feeling that something is not right. I understand that you would like to stay at a familiar dental place, especially if the hygienists and other staff members treat you kindly, but in the end it is the dentist who suggests the treatment and carries it out so having one you really feel you can trust is an important thing. I really wish you find someone kind who would be able to give you the reassurance and sense of looking forward to dental visits, as you had it with your old dentist and as letsconnect suggests, it's ok to even get a third opinion if the chemistry isn't right with the second one. We are all humans and sometimes things feel right and sometimes they don't. My last piece of advice is: do ask questions about what your dentist suggests. Dentistry is complex, but your dentist should be happy to explain to you details about any suggested treatment and give you some options.

All the best wishes, keeping my fingers crossed for your next visit and keep us updated.
 
N

NewlyAnxious

Junior member
Joined
Dec 18, 2018
Messages
2
Location
USA
Thanks for your responses. I agree that it doesn't make much sense to revisit past work, as no one can give a real answer without having examined my teeth then. I just need to find a new dentist that I trust and that can help me figure out what needs to be done now. The good news is I went to the appointment for my second opinion today. The dentist thoroughly examined my teeth and the xrays, and explained what he was looking for and why he would or wouldn't treat something. My current dentist never showed me xrays or took time to answer questions so it was a nice change. Of the six fillings I was told I needed, he said that on three of them he didn't see anything and the other three were the beginning of cavities so he would take a wait and see approach.

The bad news is it turns out my current dentist office sent the wrong xrays over. I had recent ones taken just last week and instead of sending those they sent ones from over a year ago. I got them to send the correct ones, but they weren't available for my appointment. So it's possible the good news of not having to have any fillings isn't correct anymore. Now I have to wait until after the holidays when the dentist has time to evaluate them so it's a bit stressful. I'm sure they took notes based on today's exam so I shouldn't need to be there for them to check the xrays, but it would have been nice for them to have shown and explained them. I had a much better feeling with this dentist so I think I'm going to trust their judgement on what work needs to be done and have it done at this office. I'm hoping that all goes well once they take a look at the recent xrays and that I've found my new dentist.
 
krlovesherkids777

krlovesherkids777

Super Moderator
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Joined
Jul 26, 2017
Messages
3,036
Location
Sioux Falls, SD
Newly anxious,

Glad to hear you are feeling more comfortable with this new dentist and seems they are quite reassuring and really communicate well what needs to be done and why and that goes a long way with us anxious patients. I sure know it does for me. Hope they can take a look and reassure you more on the filling! So glad to hear it went well!
 
M

MountainMama

Well-known member
Joined
Jul 1, 2018
Messages
2,606
I am glad you are comfortable with the dentist you found. I hope that the x rays they send over show you don't need more fillings.
My current dentist is the best I have ever had. She always shows me the x rays and explains things very well. She is great with patients with anxiety. That helps a lot!

I had the experience of having work done that probably wasn't needed. It was when I first graduated college, and had very poor dental insurance. The only place that took it was a dental chain. I had previously only had two cavities, and always went to my twice yearly cleanings. The first visit, they told me I needed four fillings. I had nowhere else to go, and couldn't afford to pay out of pocket for a second opinion. Plus, I was fairly naive. I ended up getting four fillings that were not done well, in all my first molars. I had to go back and get my bite adjusted four times, and it still was off. After that, I got a job with better insurance, and never had an issue until I was in my mid 30's. Three of those fillings have had to be redone.
 
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