Back in the days of silver-mercury fillings, many dentists practiced watch and wait dentistry. Before the advent of modern “minimally invasive” protocols and water fluoridation, patients would
leave the dental office with a little note in their charts to “watch” teeth with small cavities. When the cavities got larger at a later visit (they always did), the decay would then be removed and filled with silver-mercury. Unfortunately, if a patient missed a recall appointment or two, the cavity grew large enough to cause a toothache and require a crown and or root canal. The materials and techniques of the time made this the best we had to offer.

Things have changed.

We now have materials and procedures available to prevent, detect, and treat those same small cavities and to stop the process of decay at an earlier stage. This leads to more economical dental treatment, fewer patient emergencies, less toothaches, and a bit more happiness for us all.

Water fluoridation and supplemental fluoride have made a huge difference by reducing the number of cavities that we see. These supplements strengthen teeth from the inside out. Regular
topical applications of fluoride varnish and prescription toothpastes and rinses do the same thing, but strengthen teeth from the outside in. Gum disease can be treated at earlier stages with different types of antibiotics and regular cleanings. In short, with routine dental care, we can prevent problems much better than in years past.

Lasers and digital radiography (computerized x-rays) have helped to revolutionize our abilities to detect cavities at earlier stages. Digital x-rays can be enhanced and enlarged to find smaller cavities than before. Different types of laser detectors and special computer programs can be utilized to determine how big a cavity has gotten. In short, early detection allows for more conservative and less costly treatment. Plus, smaller fillings have fewer possible complications and no post operative pain.

Treatment of cavities has also improved. Anesthetics have gotten better. The dreaded dental drill has gotten quieter and less invasive. Modern materials allow dentists to preserve much more
natural tooth structure than in days gone by. As an added bonus, small tooth-colored fillings blend into teeth beautifully. No more black and silver showing when you eat, laugh, or smile.

Of course, all this technology only works with routine preventative dental care. Your dentist cannot diagnose what they cannot see. Someday, we might be able to perform dental exams from online pictures. Until then, I’d keep my regular check-up appointment.

-Please send comments to Drs. Parrish through www.ParrishDental.com.