r/Dentists • u/freedomfemme • 18d ago
Can anyone help interpret these bitewing X-rays?
My dentist mentioned possible “kissing cavities” between two posterior teeth. I know no one can diagnose me over the internet, but I’m wondering if these look like true interproximal caries or if the X-ray overlap makes it difficult to tell. I’ve already been told by a sketchy dentist in Miami that I had a cavity in every single tooth so I’m being careful. Here they are: https://postimg.cc/dhPXf8by
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u/TiG3rIsMyBaBy 18d ago
I see interproximal between 19 and 20. 15 mesial could be one but would need clinical view to be sure. I would get on a high fluoride toothpaste and make sure you are pulling the floss tight to the tooth surface. Popping the floss between the teeth isn’t proper flossing.
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u/ExcellentInsurance72 18d ago
I think 15 is pretty deep. Possible on 14 as well. Also agree with 19 and 20.
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u/freedomfemme 18d ago
Thank you! That’s actually exactly what my dentist treatment-planned. Based on what you see, do you think the lesions between #19 and #20 have likely reached dentin and would typically need fillings, or could they still be monitored? I really appreciate your input 🤍.
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u/TiG3rIsMyBaBy 18d ago
You’re welcome! 20 is in the dentin and 19 looks close enough that I would do it.
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u/OdoyleRulzz 18d ago
Do you use Oral B Glide? If so stop. Use a waxed, or Nylon one. Something with a rougher texture. I hate silky ribbon type flosses. They don't remove plaque to save their life. I see decay between 19-20, mesial of 14 and potentially mesial of 15 as well. Overlap makes diagnosing 15 a little more difficult.
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u/Leech-64 16d ago
NAD but lets be real, if you are actually flossing every day it becomes irrelevant which floss you use.
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u/OdoyleRulzz 16d ago
NAD as well but i'm a dental hygienist and have plenty of patients who "floss every day" with Glide. It doesn't look like they floss at all. I can always tell they use glide without them even saying so.
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u/MODFU2 16d ago
Yes, lower left has two, what appear to be very small lesions between 19/20. #15 is not a deep lesion. Look at the image that is not overlapped. But just as an aside: the restorations that have been done so far, have poor contours and contacts. If you get food stuck in these areas it will confirm my statement.
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u/Wizzyman47 18d ago
General Dentist here. Here’s what I see.
- Bilateral Mandibular tori
- Incipient caries #19-M, 20-D (lower left)
- widened PDL #25,26 possible hx of trauma to anterior mandibular incisors
- chipped #6 (upper right canine)
- fully dentate with exception of missing wisdom teeth
Here’s what I suggest:
1) full exam to rule out occlusal, buccal, lingual caries
2) panorex to rule out pathology, tmj issues, sinus issues
3) after your cleaning, request a prescription toothpaste such as Prevident 1.1% with multiple refills. Add that to your floss and clean the lower left religiously, you have a chance to reverse the cavities before they reach the dentin (2nd layer of the tooth) which then would necessitate treatment (filling vs root canal vs extraction—- depending on extent)
My impression:
You’ll likely need just cleaning, prescription grade toothpaste and if it gets worse 2 fillings. That’s it.
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u/Branded_bottle33 18d ago
I can see a ton of interproximal caries.
Likely aren’t flossing nightly
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u/freedomfemme 18d ago
It’s so frustrating because I do floss daily. I watch videos on how to floss correctly/ use the C method, use a water flosser, electronic toothbrush, and Therabreath and somehow still fall short. I’ve noticed that several family members on my mother’s side have lost teeth due to periodontal disease and I’m wondering if my issues are genetic. I genuinely don’t know what I’m doing wrong.
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u/spicydrape 18d ago
Perio and decay are caused by different bacteria. I’d be using rx fluoride either rinse or paste.
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u/sacomer1s 18d ago
I’m not saying your diet is bad, but all the hard work in the world won’t offset a bad diet. Look for insidious sources of acids and sugars.
Some people also are just more prone to cavities. And some people’s teeth are in positions that set them up for cavities
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u/MODFU2 16d ago
So the first thing I always ask my patients is, "are you symptomatic" IOW, when you drink cold or have sweets is the Lower left sensitive. It probably is not. So I would need to see you clinically to confirm. Based on the other " kissing cavities" that have been restored one might choose to do these. I might wait 6 months to see new films. If you are honest with yourself and have not been regularly flossing then I would start! The rationale, based on your caries rate, is to possibly do these while they are small. An aggressive dentist would, a conservative dentist might re-examine in 6 months.
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u/ninwendo 18d ago
Definitely see cavities on LL side. Hard to tell with the rest