A small hole
is not an
emergency.
It is a thing with a speed. Most of them move slowly, some of them stop, and a few of them do not. Knowing which is worth more than being quick.
604 examinations last year
297 ended with nothing recommended
118 things watched instead of drilled
0 production targets set for anyone
Every filling is the first of several.
This is the part that does not get said. A filling is not a repair that lasts for ever. It has a life, usually around ten years, and when it is replaced the new one is larger, because the old one and a little more has to come out to make room.
So the question at month zero is not whether a small area of decay could be filled. It could. The question is whether starting that sequence today is better than starting it in five years, or not starting it at all.
2mm
of healthy enamel typically has to be removed to reach a 1mm area of decay, because a drill cannot cut a hole the shape of the damage.
We would rather watch it than drill it, and we will show you the photograph either way.
Two years, two decisions
One real case, anonymised. A 1.5mm white area on the outer enamel of an upper left five, found at a first appointment and photographed the same day. Drag the scale, or keep scrolling and it will move on its own.
Month 0. Showing the note from month 0.
Watched
Drilled
-
Month 0
Watched
Nothing is done. A photograph, the date written down, fluoride varnish, and an honest ten minutes about the two spots you keep missing and the four coffees a day. You go home.
$0
Drilled
A composite filling, about half an hour. Roughly 2mm of healthy enamel comes out with the 1.5mm of damage. The tooth is now a tooth with a filling in it, permanently.
$245
-
Month 6
Watched
Re-photographed and put beside the first picture on the screen. In roughly two thirds of these it has stopped or gone slightly backwards. In the rest it has not, and it is filled then, having lost precisely nothing by waiting.
$0, or $245 if it moved
Drilled
The filling is fine and will stay fine. There is nothing to review and nothing to photograph. This is the genuine advantage of having done it: it is finished.
already paid
-
Month 12
Watched
Third photograph. By now it is either clearly stable, in which case it goes onto the ordinary yearly look and stops being a thing, or it was dealt with six months ago and is also finished.
$0
Drilled
Still fine. Around a tenth of the way through its working life. Nothing to report.
—
-
Month 24
Watched
Two outcomes. Either the tooth is still whole and has never been drilled, which is the best available result and is what happens most of the time. Or there is one filling in it, placed at the point it was actually needed rather than two years early.
$0 or $245, once
Drilled
The filling is about a fifth of the way through its life. Somewhere around year ten it is replaced with a larger one, and that one with a larger one again. Starting the sequence two years early moves every step of it two years earlier.
the sequence is running
Neither column is the right answer to every case. A hole that has broken through the enamel is filled, today, and no photograph changes that. This is about the ones that have not, which is most of them.
What actually moves the needle
Not brushing harder. Open any of these.
-
How often, not how much
A can of something sweet drunk in four minutes does less damage than the same can sipped across two hours. Every sip restarts the clock on the acid. This is the single biggest one and it is free to change.
-
A dry mouth
Saliva is the repair mechanism. Well over four hundred medications reduce it, including a great many antidepressants and blood pressure tablets. If your mouth is dry, that is the thing to deal with, not the brushing.
-
When you brush, relative to eating
Straight after something acidic is the worst moment, because the enamel is briefly soft and you are scrubbing it. Wait an hour, or rinse with water and brush before rather than after.
-
Grinding at night
It wears the biting surfaces flat and cracks enamel in lines you can see under a light. Frequently the actual cause of morning headaches that have been blamed on screens for years. A guard is $520 and solves it.
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Reflux
Stomach acid reaching the mouth at night does more damage than any diet, and it shows up on the inside surfaces of the upper teeth in a pattern that is fairly unmistakable. If we see it we will tell you to see a doctor, not sell you a filling.
-
The two spots everybody misses
The inside of the lower front teeth and the back of the very last molar. Almost everybody misses both. Priya will show you on your own photographs, which works far better than being told.
What watching actually buys you
-
A tooth that has never been drilled, which is a thing you can only have once. No filling is as good as the enamel it replaced, and no dentist claims otherwise in private.
-
Six months of evidence. If it has moved, that is a fact rather than a judgement, and the filling then happens with everybody agreeing about why.
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The whole sequence pushed back. Every filling gets replaced eventually and each replacement is bigger. Not starting is worth more than any single appointment on our price list.
1 of 3
Come and get photographed
A first appointment is an hour and $149, covers an examination, a full set of digital X-rays and a clean, and ends with a written plan you are free to ignore for ninety days. Nothing is done to you in it.
- Reception
- (555) 018-2240
- If it hurts now, until 8pm
- (555) 018-2241
- hello@alderwaydental.com
- Where
- 118 Alder Way, Ridgemont
- Monday to Thursday
- 7:30am to 5:00pm
- Friday
- 7:30am to 1:00pm