Dental Education Lecture: Early Cavities

Michelle is an ideal dental patient.  When she was little, she had braces.  Since then, she has brushed and flossed religiously.  You can notice how clean her bottom teeth are (Fig.1).  T is the tongue.  Arrowheads points to the tooth-gum junction.  In contrast, oral condition in Fig.2 is not so good.  The bottom teeth are pretty crooked.  More important is that there is a lot of tartar deposited in the tooth-gum junction (arrowheads).

Michelle is studying in a prestigious university.  Away from home, she tends to eat more of junk food.  In the last few months, she has started to have very early staged cavities in her molar teeth (arrowheads in Fig.4, 5 and 6).  Our molar teeth usually have a lot of pits and grooves (indicated between black arrow and arrowhead in Fig.3).  These pits and grooves easily trap food and germs and are starting points of cavities.  To prevent cavities, we need to place sealant to seal these pits and grooves (white arrowheads) when these molars just start to come out.  One of her molar teeth has an old filling (arrow --> in Fig.5).  The filling cracks and has a hole (white arrowhead).  Surrounding the old filling are two early cavities.  Michelle is very conscious about her teeth and finds one molar with cavities (Fig.6).  Careful exam reveals the other two (Fig.4 and 5).  Early cavities usually have not any discomfort and are easily treated without bad consequences. 

In summary, there are several things to do to prevent cavities.  First, brush and floss regularly.  Second, eat less junk food, and sweets.  Third, see dentists on regular basis for exam and cleaning.  Fourth, use high concentrated fluoride toothpaste if you are deemed to have cavity susceptibility.  The high concentrated fluoride toothpaste needs prescription.  Commercially available toothpastes contain fluoride in low concentration.  It is not enough if you are easily to get cavities.

Xin Wei, DDS, PhD, MS 1st edition 10/25/2009, last revision 10/26/2009