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Can my son almost need a RTC in three months??

My son has three to four cleanings a year. Our insurance pays for three of them. My son had a cleaning in Aug 2013 Jan,July,Oct of 2014.. In august of 2013 the dentist put sealants again on his molars. In Feb of 2014 he had sealants put on pre-molars.

He was never once told he had a cavity until Oct 2014. They said he had five.

Anyway my son had his braces off in Nov..took him to a

new dentist and my son has a huge cavity on #2 DOL with pulp cap. We don't drink soda or sports drinks.
Poster
  • Male | 47 years old
  • Medications: Zyrtec
  • Conditions: None

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Featured Answer

3 UpVoted this answer Douglas  MacLeod, DMD General Dentist General Dentist, Raleigh Kenneth L. Egger, Jr., DDS Dentist, Mount Pleasant
It is hard to answer your question specifically without a little more information. For example, how good is your son's plaque control? The fact that he needs such frequent cleanings suggests he may have a problem keeping his teeth sufficiently clean, which could promote cavities. How old is your son? Could there be some other source of sugar in his diet? Sealants do not protect all surfaces of the teeth, so they do not prevent cavities entirely, although they help. Braces can interfere with oral hygiene and make it hard to keep the teeth clean enough to prevent cavities. Braces can also prevent cavities from being seen, either visually or with x-rays, so it is possible that he had a cavity for some time, but because of the braces it was not detectable until the braces came off and the cavity had gotten large. Finally, you note you changed dentists. Different dentists have different thresholds for recommending fillings, and it is possible some of the five fillings might not have been recommended by the first dentist. It is also possible that the new fillings were diagnosed with x-rays that could not be taken until the braces were removed. If you have any question as to the diagnosis, you should get a second opinion, if the treatment has not already been done. I hope this answers your question. I am sorry to hear that your son has had these problems, but hopefully they can be stabilized. If it's any consolation, I had all my cavities as a teenager, after which I was more careful with my teeth, and have had very few problems since.
My own daughter had some "staining" on her occlusal surfaces (the biting surface). I started removing the decay which I thought was only in the enamel which wouldn't require anesthetic. Ended up being much deeper than I thought and I had to give her anesthetic to finish. Bottom line is that sealants can leak, the grooves of the teeth are very susceptible to decay, and the only way to know for sure on something like what you described is to get a second opinion before anything is done to the tooth. X-ray evaluation may not tell us anything.
Andrew Atwood
One scenario where this is possible is the orthodontic band and or bracket obscured the radiographic exam and the decay is missed and grows unobserved. In that case the decay could have been undetectable and present before orthodontic treatment began or developed after orthodontic treatment treatment and grew unobserved. Either way with good oral hygiene and a good diet this a very rare outcome. I hope this helped. Have a great day.
hard question to answer without films and a clear history from you and your son. films and intraoral photography preop would allow me to spell out a clear answer. If he had sealants done OVER top of existing cavities than what occurred could easily occur. The interpretation of prior radiographs and how the teeth grooves looked BEFORE sealants would tell me if sealants or regular fillings were indicated. Sounds like regular fillings may have been indicated. New rules for sealants according to a big-shot dentists named Gordon Christensen: if any grooves are stained AFTER pumice cleaning of the tooth to be sealed, then you can't do a sealant and have to do a regular filling. Means more expense for a lot of patients, but also less surprises like this one that your family got caught up with. Sorry you guys had to go through it. I'd follow up with the dentist who placed the sealants and see if they have any intraoral photos pre-sealing. That can tell you what you may be at risk for down the road.
Sealants on second molars are done when molars are fully erupted (at aprox. 12 years old), when there is no cavity detected on the chewing surface. Sealants should last at least 2 years. If they need to be redone, same conditions should be present: no decay on chewing surface , recently lost sealant. If the sealant is lost and too much time has past, the risks of placing the sealant over an incipient decay are high and after sealant is placed decay will grow undetected. We detect decay that starts on the chewing surface with Xrays only when decay is allready extensive. In addition to this, during orthodontic treatment they may have avoided taking Xrays.
Cavities on chewing surfaces can be hard to detect and even harder with braces, since x-ray does not go through metal brackets. It is a good thing that your son did not need to have Root Canal Therapy at this time. He is still young so the chance of healing is higher in this case.
Michael Huynh
I cannot say that a cavity diagnosis was missed by the prior dentist unless I see his/her xrays. Also, given the circumstances of braces, cavities go undetected on xray and grow large rapidly.
Some medicines can increase the likelihood of getting cavities. Also the new dentist may have better imaging , which allows for the dentist to diagnose decay more readily.
I know when this situation arises it can be very frustrating. But to answer your question based on the information given, it is not likely that a cavity would have formed in 3 months that would lead to a possible root canal. What is more likely is that a cavity started forming in the grooves of tooth #2, underneath the sealant, for a long duration of time during your son's orthodontic treatment. On these molars, sometimes the cavities look like staining on the grooves so maybe the dentist had felt it was just hard staining. But I can't tell you how many times what I thought was a small pinpoint cavity on the molars but eventually became a large cavity that led to pulp or just near it. I hope this helps
If I can read between the lines sufficiently, it sounds as if your son is getting twice the average number of cleanings and the dentist has felt it necessary to "seal" the grooves in his teeth. Sealants usually are to help prevent cavities on the chewing surface. More frequent cleanings are done on younger patients not to clean the teeth, but to get "eyes" on the teeth every three to four months. This way if a cavity starts it can be caught soon and contained to a smaller area of the tooth. Soda and sports drinks do not cause cavities, but they do feed the bacteria that can cause cavities. Controlling the bacteria seems to be an issue for your son, but without more detailed information it is hard to reply with anything other than generalities. #2 is a second molar, and it is typical for someone with 2nd molars to be able to take good care of their teeth. The fact your son is getting cavities despite having sealants on his back teeth AND he is being seen three to four times a year for cleaning, means you need to look at daily home care as the predominant reason for cavities. More information may shed light on your son's daily home care and dietary contributions to his cavities and would be welcomed for a more detailed answer. Good luck.