Surely my teeth won't fall out if I wish hard enough, right?

August 19, 2012 10:33 AM

Do cavities ever just... go away?

Went to a new dentist I hadn't visited before (first time I'd been in to a dentist in about a year) and she told me I had a "tiny cavity" on the outside of one of my molars. She described it to the receptionist as a "groove" when she told her to make an appointment for me to have it filled. She pushed on it with her little metal pokey instrument and asked if it hurt and I couldn't feel anything.

She also told me I had mild gingivitis so I am committing to A More Serious Toothcare Regime (including flossing which I don't usually do).

Anyway, I don't have dental insurance so.... is there a chance that this will go away if I am super fastidious about taking care of my teeth? And, in any case, is there a lot of possible harm in adopting a "wait six months and see" approach?

posted by geegollygosh to Health & Fitness (21 answers total)

I am not your dentist, but I had a very similar experience at my dentist this past week. Small spot on the side of my molar they've been "keeping an eye on" for a few years. Doesn't hurt, hasn't changed size. It's gotten marginally smaller, and the dentist said, "If you floss *every day*, there's a chance it could reverse and even go away."

So, anecdata from a person you've never met from a dentist you've never seen says yes, it might go away.
posted by absquatulate at 10:36 AM on August 19, 2012 [1 favorite]

IANAD, but last time I had a "small cavity" my dentist let me have a mirror when he was done drilling out the bad bits and... holy crap it was a LOT of my tooth that had rotted underneath that tiny little cavity. Ever since then I have promised myself that I will have any new cavities filled ASAP.

That said, that's only when they tell me "cavity." They've definitely done the "Keeping an eye on" thing to me that absquatulate mentions, and those usually haven't been too much of a problem. But anything they call a cavity I will make any effort to have rectified quickly.

Can they cut you a deal or give you a payment plan, since you don't have insurance? Is there a dental school nearby that might let you have it filled there?
posted by olinerd at 10:39 AM on August 19, 2012 [1 favorite]

I have had tiny cavities that the dentist chose to keep an eye on, or offered me that option. Some of them have never caused trouble, gotten larger, or needed to be filled. And I was indeed interested to learn not too long ago that tooth decay can reverse to a limited extent.

My guess would be that it won't be a big deal to wait six months. But I also learned, during a recent span of years when money was very tight for my family, that most professionaly are very helpful at answering questions like this. "Can this wait? I don't have the money to fix it right now." They can tell you yes or no, or sometimes they have suggested an alternative to me. Your dentist might suggest, for instance, a prescription-strength fluoride or some other measure in the meantime. It's worth calling back to ask for advice.
posted by not that girl at 10:40 AM on August 19, 2012 [1 favorite]

In my experience, it's pay now or pay later. See if you can work out a payment plan or else check out your local dental school, if you're near a college or university that has such a program. I don't think skimping on teeth is ever worth it, as I want to keep mine in my head forever.
posted by Ideefixe at 10:44 AM on August 19, 2012

Take care of it now. A small cavity now can turn into very expensive treatments later. Expensive, painful, long term treatments. Even if you decide to wait please floss daily and some Act or Listerine as well.
posted by Requiax at 10:45 AM on August 19, 2012

I'd suggest taking care of it now. I made the mistake of letting my tooth care regimen slide over the past few years, and had to shell out over $1000 to get it all corrected - 7 fillings plus one extraction. Fortunately, my dentist set me up on a payment plan rather than insist on the entire amount up front.
posted by Telpethoron at 10:47 AM on August 19, 2012

Response by poster: I do have the funds on hand to fill it if it needs to be done and there is a dental school that I was going to look into. And I am fairly certain I won't have dental insurance in the near future either, so if it definitely will need to be done I will probably just go ahead and get it done now. Just wanted to get some info on whether it was at all likely that I could reverse the decay.
posted by geegollygosh at 10:48 AM on August 19, 2012

Smooth surface decay patches can remain inert for a long time, I have had one for over a decade that my dentist has now declared the dental equivalent of a freckle and he does not feel it is likely to change.
posted by biscotti at 10:59 AM on August 19, 2012

I guess it depends on the type of cavity. If it was really superficial, maybe you have more time, but I think you'd still eventually need to do something about it. Either way, I would just try and get it taken care of as soon as possible, based on my personal experience.

I once had a small cavity in a molar that was described as a "wait on it and see" situation, so I did. Several visits later when I asked to have it filled, my dentist drilled and drilled and drilled and said, "Huh. You may need to have this tooth pulled." Ever since then, I did pretty much everything that was recommended straight away, since having a root canal or a tooth pulled is not only more expensive, but it really sucks.

Maybe your dentist can give you a payment plan. I've done this before when money was tight.
posted by Dr. ShadowMask at 11:11 AM on August 19, 2012

I'd say the pros of waiting and it maybe going away are far outweighed by the cons of what bad and expensive things could happen - worse cavity, cavity extending to root canal, cavity getting infected (YOU DO NOT WANT THIS, I speak from experience), spreading to neighboring teeth... I'd much rather play the safe odds and get it filled now.
posted by L'Estrange Fruit at 11:27 AM on August 19, 2012

IANADentist and this is not dental advice. I've been told by my dentist that areas of concern on my teeth (I'm not sure if they qualified as "cavities" yet) could be remineralized with the regular use of a fluoride rinse. Ask your dentist.
posted by Orinda at 11:38 AM on August 19, 2012

biscotti and orinda have it - very small holes in the enamel can heal with proper care if the underlying dentin hasn't started to decay yet. Your body naturally renews the enamel slowly over time, all on its own assuming your diet and oral hygiene is good (mouthwash and toothpaste with fluoride also provide the mineral necessary for enamel renewal). However, decay that has penetrated to the dentin usually has to be filled, because at that point it has advanced past the point of self-healing. Dentists do vary on what they think is a small cavity that needs filling; some are more conservative, some are drill happy. Dental schools will usually be upfront with you because they're not trying to milk you/your insurance for every penny compared to some private dentists, and you will automatically get a second opinion because the student work is checked by experienced dentists. See what they say and if you need a filling it shouldn't be expensive to do it with them.
posted by slow graffiti at 11:41 AM on August 19, 2012 [3 favorites]

No they do not it is a hole in your tooth. It just stops hurting after a while
posted by reese422 at 1:27 PM on August 19, 2012 [1 favorite]

IANAD You may be able to limit the expansion of a cavity with extremely good dental care and fluoride. Fluoride bonds with the tooth and strengthens it; different toothpastes have different amounts of fluoride. The longer the toothpaste is in contact with your teeth, the better.
posted by theora55 at 1:37 PM on August 19, 2012

They don't go away, but they can stop growing under the right conditions. It's like rust. If you work hard to protect it from rusting further, the rust doesn't grow. If you want rid of it, though, you can't just stare at it. You have to either grind it off or use chemicals to fix it.

Do have the dentist watch it. I ran out of cash for over 3 years, and had a bad dental scare, so I ignored a cavity. In that time it grew to the point I ended up with over $1,000 of maintenance on the tooth--a root canal and a crown. Could have gotten worse. Then again, I do have terrible teeth (2nd or 3rd root Canal now... I've forgotten--I'm starting to look forward to dentures, less maintenance and less pain).
posted by shepd at 2:21 PM on August 19, 2012

If your dental hygiene is anything less than excellent (and be honest about it!), it's better to just have it dealt with now. When it's a tiny cavity, it only requires the removal of a tiny amount of tooth and a tiny filling that's not likely to be any trouble for you in the future. Large fillings are much more likely to break/fall out/whatever.
posted by wierdo at 5:03 PM on August 19, 2012

One dentist told me I had a tiny cavity, and I ignored it for seven years. When I went to see another dentist several years later, there was no sign of a cavity. Same result a year after that. I assume the first dentist wanted to make some extra money. I don't think this experience should necessarily guide you, but it's a data point. Good luck.
posted by thegreatfleecircus at 5:25 PM on August 19, 2012

I saw a new dentist when I was living in a different city. He told me I had several cavities and needed at least two root canals. I was shocked as my teeth had been in pretty good shape. Still, I hadn't been to the dentist for over a year and thought maybe things had just gotten very bad. I decided on a second opinion. This dentist said I didn't have cavities, I had deep grooves in my teeth. He put on some type of sealant and they were fine. He also filed down some rough areas b/c my bite is very bad. Later, I spoke to a co-worker whose daughter was having more root canals from this same dentist. She was pleased that he was so on top of things; I felt like he just wanted to make money. I am very glad I got a second opinion. Several years later (maybe 10) I did have one cavity. YMMV
posted by bluespark25 at 6:31 PM on August 19, 2012

Yes. A surprising number of my 'tiny' cavities have gone away when I've been back in town at my trusted family dentist. Nearly every tiny cavity of my life has involved a new dentist who seems to be trying to turn an insurance buck.

Trusted dentist on the other hand has offered me prescription fluoride applications and toothpaste. Tiny cavities need a bit of help, but with an up-and-up practitioner, you may be able to avoid the drill.
posted by mmdei at 8:39 PM on August 19, 2012

I am not a dentist. I've read a few articles and studies on remineralization of teeth which suggest some reversal of cavities has been detected. Novamin is mentioned as a product that is supposed to help.

But none of the products that have Novamin in them actually claim they can remineralize teeth, so maybe the data isn't conclusive enough to allow them to say this.
posted by eye of newt at 10:39 PM on August 19, 2012

I've heard that vitamin D can reverse tooth decay, but the evidence is sketchy. I take vitamin D every day, but I don't expect my cavities to magically fix themselves.
posted by griselda at 11:59 AM on August 21, 2012