Let’s Watch It

Author: Kimberly N. Powell, DDS, MS

You come in for your 6 month hygiene appointment, and your attention is directed towards your radiograph to see a small dark spot on the outer border of your tooth, between two teeth.  You’re informed that this is an area of decalcification, where your tooth is starting to breakdown, or of early formation of a cavity.  Instead of planning restorative treatment for that tooth, you’re told, “let’s watch it”.  When a carious lesion is found in JUST the enamel, there is a chance for remineralization of the area. Meaning, the lesion will not progress to the dentin (the layer below the enamel.)  For remineralization to occur, one of the most available products that can be used is your own saliva.  Saliva keeps teeth rinsed and at a neutral to alkaline pH which offsets the acidic pH needed for caries formation.  One’s diet must also be considered as a diet rich in carbohydrates, sugar, acid, and the resulting acidic oral environment is the perfect atmosphere for the progression of caries.  Fluoride treatments have long been used to help remineralize teeth.  These treatments can be administered via your fluoride toothpaste, prescription fluoride drops applied in mouthguards, and prescription toothpaste like PreviDent.  It’s repeated often, but brushing twice a day and flossing at least once a day are enduring protocols for fighting caries formation and progression.  In a rather healthy mouth, efforts to remineralize teeth is beneficial and possible when the noted recommendations, adequate saliva flow, a healthy diet, fluoride use, and proper oral habits, are followed.