Repairing dental cavities

Why, exactly, is it required to drill away at teeth when repairing decay?

In other words, is there any way I can go to the dentist for the first time in three years (after having been told I had one or two small cavities that would probably need to be filled next time) , have the needed repairs, and not having someone playing with power tools in my mouth?

(I fully acknowledge that I am an idiot for having been told that I’d probably need some work done and dealing with it by running away and hiding. I am an irrational coward.)

I believe they have to drill away the decayed matter that is eating up the tooth before they fill in the hole that the deacy has started. If they didn’t, the tooth would continue to decay around the filling.

Well you could get those white composite fillings if the cavities are smaller in nature, and this allows the dentist to remove less healthy tooth structure than placing amalgams. You would still have to get some removed I guess though.

You might want to find a dentist who offers nirtrous oxide (laughing gas) to help calm your nerves. It helped me but didn’t really make me laugh.

They can also do the drilling by laser.

Not only do they have to remove the diseased part, they have to get a good hole to put the filling into.

Some dentists use something called a water drill (one brand name is the Waterlase) which uses a laser and a stream of water to cut the decay. It might be more comfortable for you.

I completely understand - I have very soft teeth and am terrified of the dentist. I had to have several thousand dollars of work done because I put it off for so long. Check around - ask friends - and find a dentist that understands fearful patients. My dentist prescribes valium for me for the night before and the morning of the procedures; he says he does it in self defense so I don’t rip the arms off of his exam chairs. It’s a low dose but it helps a lot.

Look for a dentist who specializes in sedation dentistry.

Mine uses gas and novocaine, on me, and it’s brilliant. It has radically changed my life. I only regret I waited so long to seek out such a dentist. They also do things like partial and full sedation, but I don’t need that.

Truth is my fear was directly related to the fact that novocaine has never been 100% effective in numbing my teeth. Something that never once phased any of the dentists I had. Seems it didn’t really bother them all that much. I became more and more fearful of going to the dentist, never sure when I’d have another horrid experience of non frozen tooth drilling. I averaged about every 4th or 5th time, it was brutal.

I came on the Dope one day and complained and someone recommended it to me. I went directly to the phone book and have not looked back since. I could kick myself for having put up with having in shrugged off by dentist after dentist as no big deal. I repeatedly asked if perhaps I should switch to a dentist who uses gas, only to be put off as not necessary.

Last time I visited the dentist, he used an Ozone treatment on a couple of teeth which had the beginnings of decay. I’m not sure if it’s suitable for all situations but it’s completely painless and there was no drilling involved. Not all dentists have the machine so it’s probably worth ringing around beforehand.

Another vote for finding a dentist that will knock you out. I’m not that freaked out by dentistry, but my dentist would give me gas before he even gave a novocaine shot - why remember that if you don’t have to? ‘Laughing gas’ just makes you feel really really high, if you’ve never had it. You are semi-aware of what they are doing but you seriously could care less. He’d also clap a pair of headphones on me with the comedy CD of my choice. I was generally too high to follow it, but it helped to not hear drilling. And they can put in a bite block so you don’t have to work at keeping your mouth open. Try not to put off dental work - you can end up with gum problems and all kinds of nasty stuff.

Good luck with finding someone, NinjaChick.

I’d love to find someone who’d cheerfully knock me into Loopyland before doing anything - unfortunately, I don’t think many dentists in my area take my insurance, and I can’t afford to find someone out of the network. Apparently whatever plan I’m on doesn’t even require a co-pay (I think, though I need to check with my parents about that*), which is the only way I can afford even a single trip to the dentist.

To hijack my own thread a bit - what’s a likely scenario for how this all works? I’ve never had any dental work done beyond having a tooth pulled when I was five (which I don’t really remember). I find a dentist and make an appointment, and tell them that I know there’s a problem but I have no idea what will need to be done/how bad it is/etc. I assume I go in and they need to start by doing a full cleaning, right? Is it likely I could convince them to skip that, just do what absolutely needs to be done, and get it over with? I’ll probably have to make another appointment regardless for the actual fixing, once they know what needs to be done, right?

*I’m a full-time student and still under my parent’s insurance. They periodically e-mail me nagging me to go to the dentist/get my eyes checked/etc, which I then ignore, and they ignore that I’ve ignored it.

Sometime dental front desk person here.

You will probably need to go in for an evaluation appointment/exam. People call all the time and want us to schedule them an appointment to fix their teeth. It’s impossible to schedule an appropriate appointment without looking at you first, unless you’re a current patient and we’re very familiar with your mouth.

The dentist I work for fixes problems, especially those involving existing pain, before scheduling a regular cleaning, and I imagine that’s pretty standard. You will probably be pushed pretty hard to schedule a cleaning, though, and it’s the smart thing to do.

I know you hate the dentist (we see very fearful people all the time), but going in for a cleaning every six months enables the dentist to catch things before they become major problems. Getting twice-yearly cleanings, even if you HATE them, has to be preferable to having an abscess, a root canal, or even a crown, all of which I have personally experienced. They are Not Fun.

Call around and be frank about your fears with the receptionists. Ask what they do for fearful patients. A decent receptionist will be able to give you lots of information and hopefully allay some of your worst fears.

Unless you are having tooth pain, I would call the dentist to set up an appointment for a cleaning. Let the DENTIST or the hygienist tell you whether the spots which should probably be filled next time have moved into “Make an appointment for a filling now” territory, or whether they are still in the "hmm, these should probably be filled next time
territory. I’ve known people who visited their dentist every six months for a cleaning, who went for several appointments where they were annoyed by the feeling that the dentist or hygienist were scraping the teeth vigorously enough to create a cavity if one did not already exist, but the dentist kept saying “we’ll keep an eye on it, it may need filling in six months”.

If you are having tooth pain, mention it when you make the appointment. It may make getting a filling much more urgent.

Another reason for the need to drill is to shape the cavity properly, so the filling doesn’t fall out. It’s got to be wider below the opening than at the opening, otherwise there’s a chance that it can slide out. Additionally the drill etches the inside surface, which kind of serves the same purpose (like the threads on a screw versus the smoothness of a finishing nail).

As to why they have to drill period? The “cavity” is the result of drilling. The actual decayed spots are really called “caries.” You need to have a cavity to fill. In many cases, the decay is below the actual surface, to which you need access.

I have been having 6 month cleanings for the last 13 years, since I got insurance. In the last 8, I have had 3 abcesses, 2 root canals, and am waiting right now for the second crown, plus the ceramic cap on my front tooth that has now fallen off for the 3rd time. And the first tooth I got a crown on ended up getting pulled because of the infection that was eating away my lower jaw. I can’t afford the implant or crown to replace it right now. :frowning: And I won’t go into the things I had to have done for the first crown. [shudder]

Regular cleanings are a good idea, and should be done if you can afford it, but they don’t mean you won’t have problems with your teeth.

No, you’re right, and I didn’t mean to say that you wouldn’t ever have anything wrong (I’m having a crown issue myself right now and I am a regular dental patient). Just that your chances are better to avoid the worst stuff if you’re having your teeth looked at regularly.

What dentists do is they remove all the source of bacterial infection that is causing the tooth decay and then properly shape that “hole” so that the filling material will best fit and not fall out.

The drill is makes this process MUCH faster, MUCH more efficient, MUCH more precise and safe!

I did just call and make me an appointment for a cleaning, so we’ll see how it goes from there. (Took me forever to find someplace that will do weekend or evening appointments [I work until 4:30 and can’t take off early], and is within walking/biking/bus distance [I don’t have a car]). The receptionist did kindly point out that I’m not the first person to be nervous about dental work and have gone for a while without a cleaning.

I feel kind of ripped off - as a kid the message was “brush and floss and you’ll be just fine”. I do so religiously, and my teeth are not fine. False advertising, I tell you.

Plaque that brushing and flossing and rinsing can’t eliminate is going to grow no matter what. How bad depends on your body chemistry. People like me need regular professional cleanings, which are not the most pleasant experiences, but shouldn’t be painful, and you get used to it after a while. I have a friend who asks for gas just for her regular cleanings. I think that’s a bit much, but everybody’s different.

Don’t feel too bad. My wife is a dentist and has the most horrible teeth you could image. Crowns, root canals, fillings, bridges. Yeah-gods!