decaying teeth

[ckent]

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My dentist was giving me a filling and drilling out all of this decay from my tooth the other day. He told me that he couldn't get all the decay out because it was too deep so he put a layer of fluoride over the decay and then put the filling out over that, but that he might have to go in later and fix it if it keeps on decaying. Does anyone know how likely that the layer of fluoride will stop any further decay? What will the dentist have to do if it keeps on getting deeper? Thanks.

 

[Ineedanassociate]

Dear Clark Kent why don't you ask your dentist these questions? He or she was there and knows exactly what the situation was at the time of tratment. I know I would much rather have my patients ask me what was going on if they felt the explaination I gave them wasn't enough information than online information on a student chat room with a sketchy history at best.

 

[ckent]

I go to the dental school and see a dental resident and he never gives me enough time, I don't want to make him upset by asking too many questions because he is going to be going back in later with the drill to do some of my other teeth 😱 so I would like him to be in a good mood the next time I see him.

 

[Ineedanassociate]

Do you have his e-mail address? Maybe a forum were he isn't under the time constaints that he is under in the clinic? Let him know from me a 12 year veteran in private practice that letting people know what is going on is as important as doing a good job! R.Scott DeBruin,D.D.S.

 

[DrJeff]

Exactly, exactly, exactly. A resident in particular should be using the residency time not only to advance their clinical skills, but also their communication skills. If a dentist is unable to explain a procedure in plain english at about the comprehension level of a 6th grader, then without realizing it, he/she will end up loosing many patients from their practice. An educated patient is the best kind of patient, because they realize the need to fix the problem and why some ways available to fix the problem are better than others. That comes from 5 years in clinical practice.

 

[pn229]

Ckent
The core procedure for an "indirect pulp capping", which was what seemed to be done in this situation, involves not removing all the decay. On top of this the Dr. would place Calcium hydroxide (Dycal probably) to iniatiate formation of stronger tooth structure (secondary dentin) which would stop the decay from developing further. On top of this, the Dr. would place a sedative intermediate filling, something like IRM, and check the carious lesion at a later date to see whether secondary dentin has formed. If it is hard, then the procedure was succefull, and the dentist can put a final restoration. If not, the Dr. would remove the decay, which may lead to a perfotation of the pulp chamber, leading to a root canal.
From what you desribed, putting Flouride onto the cavity does not seem to be a core procedure I am aware of. Flouride is used mainly to remineralize enamel, the outer tooth structure, help it become stronger, and stop bacteria from breaking down tooth structure. I have not heard of the use of Flouride on a cavity after it has been prepared. Can some one else shed some light on this matter?

 

[DrJeff]

The dental resident may have very well placed a flouride releasing base such as Vitre bond instead of utilizing IRM. Which ever base material was used, long term chances of successful treatment(i.e. successful final restoration and an asymptomatic vital pulp) are likely between 1 and 3 and 50/50. Likely though the resident will receive a geographic success in this case as it it likely that June 30, 2002 (the last day of the residency) will come before the tooth becomes symptomatic 😉 😱

Just remember 1 residents geographic success is a future residents learning experience 😀