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Dental Technology – How accurate is that laser that tells you if you have a cavity?

    Recently, a friend of mine who has been a very regular patient for several years came in to get a “second opinion” from me.  He has been a student in a large city and opted to have his regular recare appointment there, with new dental technology, rather than traveling home.  However, he was shocked because the “new” dentist, who by the way attracted new patients with a coupon for free x-rays that were at best questionable in quality, had found seven cavities that I had not just six months ago.  There is something very important to mention about my friend who I have known all of my life….  He is meticulous in his appearance, demeanor, and  oral hygiene.  Granted, I did diagnose one “small” cavity 6 months ago, which was his first. (He’s now 32.)Dental Technology

    After inquiring further about my friend’s experience, it became clear that this dentist purported to be “drill-less” and “preventive.”  She had used a new dental technology instrument to very accurately diagnose every little stain in the grooves of my friend’s teeth.  If my friend and I were not so close, the dentist would have very effectively “sold” about $1000 worth of Overtreatment, in my opinion.  Although I believe that using a laser as a diagnostic tool has a great deal of value, it can be used inappropriately, just like any new technology.

    First, the tool was not incorrect.  However, most dentists will admit that just about every groove on a tooth has the startings of a cavity.  This, by the way, is one of the reasons why we use sealants and not fillings in this situation, but that’s another topic in itself.  Although small cavities probably were present, they were not large enough to justify removing healthy tooth structure to restore.  Also, these cavities may remain dormant and even possibly reverse over time with fluoride use; a filling, however, has about a 5-year lifetime which would result in a continuum of progressively bigger fillings during my friend’s lifetime.

    Second, the term “drill-less” that many dentists are using today to attract new patients does not and cannot mean that a drill is never used.  Lasers and air abrasion technologies cannot remove old silver fillings or prepare teeth for crowns.  Although these technologies are promising and very “cool” to use, I fear that they are being overused to make a buck from minor “normal” irregularities.

    Lastly, acknowledging that my friend did indeed have several small cavities as reported by laser technology, the history of the patient is very important in a diagnosis.  If I had used the laser on this same patient who had already had several fillings in his lifetime, I would probably have been more prone to recommending the fillings that the other dentist did because of a history of a high decay rate.  However, my friend had never had a filling.  Therefore, at age 32, it would be safe to deduct that he had a very low decay rate and, therefore, require a less aggressive approach.

    The moral of the story is this:  when seeking a new dentist, be sure that you know the philosophy behind the use of new dental technology.  Is it for your benefit or the dentist’s?  Keep in mind that often it can be both.  However, your dentist should be willing to answer you honestly if you ask.  Technology is great if it’s used the right way, but it doesn’t necessarily replace common sense. If you would like to receive a second opinion, or see Dr. Huff for a regularly schedule appointment in Dover, OH, feel free to contact us today.

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