Question about cavity progression and x-rays

[bordor]

My dentist said I have a few cavities he wants to fill. These are cavities he found when examining the surface of my teeth. I can't afford to get the fillings right now but he said that's ok, they don't need to be done right away, because they are small. At the same time, I know I should not let these cavities get too large before filling them. So I asked if on my next check up he could do an x-ray to see if they had grown larger. He then said they don't show up on the x-rays so he couldn't be sure what size they were. This left me feeling any future x-rays to monitor the growth of the cavities would be useless. But after I left the office and thought about what he said I felt confused. At first he said the cavities were small, then he said he couldn't be sure what size they are. Anyone have an idea why he might be saying that? Also, why do some cavities show up on x-rays and others not show up? What is it that makes a cavity visible on an x-ray? I'm guessing that once a cavity is large enough, it is visible on an x-ray? Or is that not the case?

Is there any way to monitor the growth of a cavity over time, so at least I would know if the cavity had really enlarged and a filling was urgent? Any recommendations for a way I could work with my dentist to do this?

Thank you for your help.

 

[MattKW]

If he saw it on your surfaces, then I'm assuming this was in the biting (occlusal) fissures of your teeth. Taking Xrays of early occlusal decay will only show it up ~60% of the time; by the time you can reliably see occlusal decay on an Xray, it's moderately large. Xrays are more useful for early decay between adjacent teeth (interproximal decay).
Did he suggest any less invasive treatment, e.g. fluoride applications, fissure sealants, PRRs?
Based on your story, I think I'd wait and monitor.

 

[bordor]

Hi Matt,

Thanks for replying. The feedback you've given me is helpful and I appreciate it.

Here is what I know about the cavities: one is occlusal, as you said. the second is on the front of one of my front teeth. I do not know specifically where it is.He just pointed at the tooth surface in a general way without pinpointing a spot. I cannot see anything there with the naked eye. The third is between two of my upper teeth, on the upper inside edge of the tooth. This is the one he said the most about because on my visit the day before he probed that area with the explorer and said it was sticky. He also said the decay had penetrated the enamel. also I had noticed some darker discoloration in that area myself awhile back, but I did not think much of it because I have had some tooth discoloration in that general area for a long time. I do not have pain in that area, or sensitivity to hot or cold drinks.

So one is occlusal but the other two are not - is there a reason they still wouldn't show up on the x-rays? maybe they are still too small? If I understand what you said it sounds like those would be more likely to show up on x-rays.

How do you determine that decay has completely penetrated the enamel and reached the dentin? X-ray visibility isn't needed to do that?

To answer your other questions, he did not propose any other treatments. He said I had three cavities that needed to be filled and should make an appointment for that. Since I can't afford to do that right now, that is when I began to ask him more questions about the size and location of all the cavities and if they could simply be watched to see if they enlarged.

Maybe on my next check up I should seek another opinion. I'm wondering with current technologies, would I be able to request having my x-rays emailed to me or something like that? Maybe it would be valuable to have them on hand.