Pit and fissure stains or cavities?

I was at the dentist on Friday afternoon because I'd noticed black marks in the grooves of some of my molars and I thought they were cavities. The dentist looked at them and did some x-rays, and confirmed that one is definitely a cavity, but there are several which he says he's not sure about. He says that they might just be stains in the teeth, or they might be early cavities, but he can't be sure, and he wants to drill one of them to check........is that normal? Surely he should be able to tell the difference between a cavity and a stain, and shouldn't a cavity show up on the x-rays? Should I let him drill a tooth to check??

Pit and fissure stains or cavities?
I would ask the dentist office for the x-ray's....or at least a good copy. Then make an examination appointment w/ another dentist and let him look at them. Always get a second opinion when you're not sure about the recommended treatment. It's not good to dril on a tooth if it's not necessary.


Good luck!


Happy Holidays!
Reply:Hi.


First, xrays will only show two things: Cavities that are between your teeth, or cavities that have started in the pits/fissures but are large enough to have entered the 2nd layer in your tooth: the dentin.


When a dentist does an exam, he uses an "explorer" to feel your teeth. Enamel is very hard, but when there is decay it becomes sticky. So, he may have felt a suspiciously sticky spot when he was examining your teeth.


If your dentist is wanting to drill one of your teeth, I'm guessing he's wanting to do what is sometimes called a "burr and seal." He'll get the stain (or possibly decay) off and then seal the tooth back up.


I would let him. He's not going to drill enough to damage any of your tooth structure. If it's not a large cavity, he will probably just seal it and send you on your way. If it is decay, at lease he will have caught it and can do a smaller filling now rather than a larger one later.
Reply:Sometimes a very small cavity does not show up on an x-ray. The dentist will also use an explorer (the small hook instrument) to see if the stain is a cavity or not. But if the stain is in the grooves of the molar it can be very hard to get the explorer into such a small place to check for caries. Drilling to make the grooves alittle bigger so he can get a better look is normal. If it's a cavity then you will get a filling. If it's not then the dentist would place a sealant to protect the grooves from further staining and/or a cavity.
Reply:KAREN,


SOMETIMES A STAIN APPEARS AS THOUGH IT IS A CAVITY, BUT ON EXAMINING IT WITH A DENTAL EXPLORER IT IS NOT A CAVITY. SOMETIMES AN X-RAY WILL ONLY SHOW A CAVITY ONCE IT'S BEEN THERE FOR AWHILE, AND SUFFICIENT DAMAGE HAS OCCURRED FOR IT TO SHOW UP ON AN X-RAY. FYI SEE BELOW:





Locating hidden decay before it destroys tooth structure (from the inside out) is a major goal at Family %26amp; Cosmetic Dentistry of Sugar Land. Finding cavities beneath the hard surfaces is challenging because the disease process can start through microscopic defects in the hard surface can spread into the softer tooth structure beneath the surface.





Recently FDA approved this amazing laser cavity finder which instantly and accurately finds cavities in areas x-rays rarely see and the dental pick misses 76% of the time.














Diagnodent is a major breakthrough that allows us to monitor the areas below the hard surfaces. We can now locate hidden decay, and with treatment stop the spread of the disease before it destroys the tooth from within.





DOES YOUR DENTIST HAVE THE DIAGNODENT?
Reply:Probing for "sticky" fissures is the traditional method of detecting decay in the fissues, along with plain old eyesight.


Xrays are only about 60% reliable in finding occlusal decay. By the time it can definitely be diagnosed from Xrays alone, then it's a significant hole.


The Diagnodent is very useful too, and I use mine regularly. Despite manufacturer's cliams, it is not infallible. Sometimes it will pick up false positives.


All these diagnostic tools are part of a jigsaw, along with the experience of the dentist. It is a reasonable idea to lightly bur into one of the suspicious fissures to determine the true significance.
Reply:No, you can't always tell the difference between a stained groove and a cavity. That's why I spend $2,000 on a laser thing (Diagnodent) to help with the diagnosis.





As far as "drilling it to see," this is kind of a crude way to put it, but I would agree with that. Often, when I "seal" a groove, I am actually doing what is called a "preventive resin restoration." I "open up the groove" a bit (ie: drill into it superficially) and take a better look. If there is no problem there, I apply a flowable composite resin, which is a lot better than a typical groove sealer anyway. If there IS a problem there, I just numb up the tooth and drill normally to get rid of the cavity and place a filling.





If your other groove shows decay on the x-ray, the odds are that the ones that look "not so bad" are indeed in need of a proper filling. These things tend to progress at nearly the same rate on each side of the mouth.
Reply:Your dentist should be able to use an explorer on the suspicious areas. If the point of the explorer sticks in the pit/fissure, then there is a cavity. If not, it is just a stain. I think drilling is a definite NO NO.
Reply:Yes he should be able to tell by probing them and also on the x-rays so i would get a second opinion.By probing them he will feel if the staining is soft in which case its a cavity. What your saying sounds a bit dodge hun so a second opinion is my advice! Good luck x