Dentist said I have a small cavity that wasn't seen on the x-ray and said I should get a filling?

Question

So, I went to the dentist for a typical cleaning and the dental hygenist (a family friend) cleaned my teeth and said my teeth were fine, she used a dental explorer to look over my teeth and said she didn't see any problems. At 20 years old, I have never had a cavity. I got x-rays done after that and the dentist said I didn't have any cavities and that I did have an area that appeared weak. He then went over my teeth with the dental explorer digging into them really hard, like he was trying to break my enamel or something. I didn't notice the probe sticking to my teeth, but he said it did slightly to two of them. The dental assistant was blowing air on the two teeth that appeared to have cavities while the dentist kept digging at them with the explorer. He afterward tells me that I had two very small cavities that weren't visible to the naked eye, and that they were so small, saliva filled the holes so they weren't visible until air was blown on them. 
So, does this diagnosis sound sketchy to anyone else?
Also, if there actually cavities on the teeth, what should I do if they are that small? Would flouride or another substance be able to remineralize over the small hole?

PenPress · Accepted Answer

1. The following article will show why dental exam findings may vary based on clinical and radiographic findings :

http://www.associatedcontent.com/article/682917/concerns_with_dental_decay.html?cat=5

2. It is also true tha when a tooth is dried out you can see the discoloration because of decalcification can be more visible.

3. From your description though it is clear that the cavities are very very small.

4. In this situation the opinion varies. Some dentist feel okay with the idea of "wait and assess". In other words "watch". That is how we list it. Other dentist prefer to drill into the tooth and place a filling. 

The logic behind "watching" is to give it some time to see if it reminaralizes. Also, such benefit is given to only the patients who as a routine demonstrate good oral hygiene and show up for their routine checkups religiously. If the dentist has doubt about that he / she will definitely insist on placing the filling, assuming that the next time he / she sees you, it will be a full blown cavity causing significant problems. Nobody wants the liability of "overlooking" or "failing" to diagnose.

Only you will know how many of these points apply to your case.

5. I would talk to the dentist and ask if he / she would recommend using a fluoride rinse like the "ACT" to promote remineralization first. 

6. Inform them that you DO NOT want a filling at this point.

7. Remember, a dentist would never contradict himself by saying there was nothing on the x-ray and then clinically determine a cavity if it was not there. 

8. Also, a hygienist is licensed to do cleanings. Legally they do not have the knowledge to interpret the x-rays. 

I am sure your friend is knowledgeable, but that can never be equal to that of dentist. Otherwise, she would be a dentist, period. 

Is is very true that when the teeth are dried you can see the discoloration better. 

When your friend first checked with the explorer, she did not dry the teeth. So, she wouldn't know.

9. Again, if the cavity is incipient and there is no symptoms, ask him if he feels comfortable to "wait and assess / watch" .

Meanwhile, use "ACT", brush and floss.

Avoid too much snacking between mela, candy, soda, etc.

10. One last thing, you always can seek a second opinion. You have the right to go to another dentist and get evaluated. 

Good luck !!

Note : I got my first cavity when I was 19. It took me at least 2 weeks to accept that fact. I got 4 more 9 years later. That was it. Once I got those filled I have not gotten anymore. I am 41 now. Yes, I am a dentist and I did get cavitites. It is not the end of the world !

? · Answer

Getting a cavity filled is not accually that bad, don't look at pictures of it online because it will give you nasty looking pictures, the injection for the numbing isn't painful, the dentists now use a secondary numbing agent that is like a jell that they put on a cotton swab and put on the gums next I the tooth, that numbing agent will make it so that you will not feel the shot. You do not want to get a cavity filled without the numbing shot!

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Dentist said I have a small cavity that wasn't seen on the x-ray and said I should get a filling?

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