The Cavity in the Mirror May Be Bigger Than It Appears

Tooth cavities are usually bigger than they look on the outsideYou know that little message in the passenger-side mirror on all cars?  The one that says, “Objects in the Mirror May Be Closer Than They Appear?”  It’s basically saying – objects in the mirror ARE closer than they appear, so BE CAREFUL!  Well, it would be really nice if patients could understand that when dentists say, “There’s a cavity in your tooth,” they’re really saying,

That cavity in your tooth may not look big, but I promise – it’s bigger than it looks!

 Cavities Are Usually Bigger on the Inside Than the Outside

Here are a few little factoids that aren’t really known outside dentistry:

  • Computer monitors are capable of displaying 256 shades of gray
  • The human eye can only detect about 100 shades of gray – less than 50%
    • Therefore, the human eye can not see as much detail as technology can capture
  • Studies have shown that dental cavities are usually about 30% deeper than they look on x-rays, because that’s close to the difference in what the eye can see
  • Cavities always start as very small holes through the enamel
    • Once cavities break through the enamel to the next layer, called dentin (about 15% softer than enamel), they can grown much faster
    • Once a cavity gets big enough inside the tooth, the outside enamel is too undermined and collapses in, making the hole
  • Even big cavities don’t always hurt, but oddly, sometimes small ones do – depends on the person’s sensitivity

See How What Looks Like a Little Cavity is Actually BIG!

Cavities are usually bigger than they look.

“When Will the Cavity Start Hurting? Let Me Check My Crystal Ball.”

Dentists can't see the future and know when your tooth will hurt.It’s one of those kinda crazy things we deal with as dentists……the expectation that we can somehow see the future and tell you exactly when your tooth will start hurting.  Seriously, we get asked almost every day; here’s a sample conversation:

So Dr. Payet, how long can I wait to get this tooth fixed?

Well, Mr. Smith, you can wait until one day before it hurts or breaks.

When will that be Dr. Payet?

Mr. Smith, my crystal ball is cracked, the Tarot cards got dirty at lunch, and the tea leaves ran out, so I’m afraid I don’t have an answer.  My best recommendation is to get it fixed now, then you don’t have to worry about it.

Can it wait until my insurance takes effect in 12 months?

Good question.  I still don’t know.  

Well, right now’s just not a good time for me.

Mr. Smith, you can choose to get it fixed whenever you want.  Just please remember – if it starts hurting or breaks, you waited too long, and it will almost guaranteed cost more and take longer.   Would you like it cheaper and faster, or more expensive and longer?

I’ll have to get back to you about it, Dr. Payet.

Ok, so I’m actually not that sarcastic with patients, because it is a legitimate question and deserves a legitimate answer, but unfortunately, the only answer I have is, “I don’t know when it will hurt or break. ”  What I CAN tell you for certain is this: if tooth decay has broken through the enamel, nothing can stop it or reverse it, so it WILL get bigger. 

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