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Conflicting Diagnoses of my son's cavities

 
Conflicting Diagnoses of my son's cavities
Added: August 24, 2005 - 7:53 PM
By: Patient Email Withheld, Mentor, OH
Need Dentist / Specialist: Yes  
Provide Cost Estimate: Yes  
X-rays Available: Yes  
Case Summary
Filling
Teeth:  
Case Description
My five year old son's teeth appeared to be in fine condition to the dental hygienist during the cleaning and exam, but the x-rays showed four dark spots on his molars. Our family dentist pointed these out to me and gave me some options for having them filled. He gave me the name of a very good pediatric dentist who also teaches at a fine University in our area. While the bedside manner of this pediatric dentist was rather weak I felt confident we would be treated fairly. I was shocked when this dentist told me my son actually had eight cavities! He did point out more spots in the x-rays, but I had trouble seeing them. How could my family dentist possibly have missed these other four cavities? I have a longer patient relationship with my family dentist and feel inclined to trust him. Who am I to believe? Filling these cavities will cost us a significant amount of money, but I certainly want to do the right thing for my son.




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Reply: Conflicting Diagnoses of my son's cavities
added: August 25, 2005 - 7:08 PM

Cost Estimate: $ No Estimate at this time. Additional information required.
Reading x-rays often is opinion and science. Some areas of decay are unmistakeable, and some areas can be subjective. In the case of adjacent teeth, many times the definite area is prepared which allows access for inspection of the questionable sites.

The back "baby" molars remain in position until 12years old, or longer. These teeth guide the permanent teeth into position. Therefore, proper treatment and management of the primary teeth has long lasting consequences.

 
Reply: Conflicting Diagnoses of my son's cavities
added: August 26, 2005 - 4:09 PM

Cost Estimate: $ No Estimate at this time. Additional information required.
It's not always a clear cut case of "one vs. the other." It may be a case of subjective interpretation. You should ask the pedodontist to clearly show you the cavities, both clinically and on the x-rays, on a viewbox and with magnification if necessary. It could be the "cavities" are only minor interproximal etchings and not truly into the enamel...just surface blemishes. If they are truly into the dentin (next layer in) then that's a different story and they need to be filled. Chances are a 5yr. old is not able to floss very well if at all. Usually good brushing is all you are able able to hope for. Then again where are these cavities? On the top (occlusal)? On the sides (interproximal)? If you could not easily see them on the x-rays do they truly have to be filled at this time? Keep in mind the child will probably need to be anesthesized and the cavities prepped ("shots and drills"). Hope this helps and good luck!
   

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