Dentist missed lost filling 
Author Message
 Dentist missed lost filling

Hi,
        Background: I have four fillings in the
back lower molars, these were put in about 25 years ago.  X-rays show
them to be very shallow.  My parents weren't there and at age 10 or so
I wasn't too clear about what was going on.  A couple of other dentists
I have talked to seem to think they were quite possibly prophalactic
fillings.

        One of those fillings cracked and was replaced a year or so ago.
Also in the last two years I developed a cavity in one of my upper incisors
which was filled.

        To the best of my memory that is the extent of my dental history,
at least as far as fillings go. (I also have a couple of horizontally
impacted Wisdom teeth but that is another story)  Never had any braces.

        About 5 weeks ago I lost a filling, I am a great procastinator and
three days ago my wife surprised me by telling me I had an appointment for
my 6 month checkup.  I went in the next day, I was a bit late, it was just
before lunch.  The Dentist asked if anything was new and at that point I
had forgotten about the missing filling.  She took an X-ray, examined,
cleaned and polished my teeth, checking for depth of receding gumlines
and ?mouth cancer along the way, examined my x-ray and gave me a clean
bill of health.

        My dentist seems competant enough, she was probably in a bit of
a hurry.  

        I don't particularly like her "bedside manner" and am thinking
about changing dentists.  I also have some mixed feelings about those
fillings in the back.  Combined with embarrassment for having forgotten
to tell her about the missing tooth (and at not having dealt with it
sooner) that all added up to my not saying anything when I did
remember.

        I can see all my back fillings and my wife can see the filling in
the incisor.

        I know that to be on the safe side I should make another
appointment for a dentist to have a look but I want the general opinions
of the dental professionals on this newsgroup about the situation...
How hard is it to miss a missing filling?
If it is missing and not noticible how much damage could there be?
                                                   is there likely to be?
Other thoughts?

Robert


Real Men change diapers



Tue, 26 Jan 1999 03:00:00 GMT
 Dentist missed lost filling

Quote:

>Hi,
>    Background: I have four fillings in the
>back lower molars, these were put in about 25 years ago.  X-rays show
>them to be very shallow.  My parents weren't there and at age 10 or so
>I wasn't too clear about what was going on.  A couple of other dentists
>I have talked to seem to think they were quite possibly prophalactic
>fillings.
>    One of those fillings cracked and was replaced a year or so ago.
>Also in the last two years I developed a cavity in one of my upper incisors
>which was filled.
>    To the best of my memory that is the extent of my dental history,
>at least as far as fillings go. (I also have a couple of horizontally
>impacted Wisdom teeth but that is another story)  Never had any braces.
>    About 5 weeks ago I lost a filling, I am a great procastinator and
>three days ago my wife surprised me by telling me I had an appointment for
>my 6 month checkup.  I went in the next day, I was a bit late, it was just
>before lunch.  The Dentist asked if anything was new and at that point I
>had forgotten about the missing filling.  She took an X-ray, examined,
>cleaned and polished my teeth, checking for depth of receding gumlines
>and ?mouth cancer along the way, examined my x-ray and gave me a clean
>bill of health.
>    My dentist seems competant enough, she was probably in a bit of
>a hurry.  
>    I don't particularly like her "bedside manner" and am thinking
>about changing dentists.  I also have some mixed feelings about those
>fillings in the back.  Combined with embarrassment for having forgotten
>to tell her about the missing tooth (and at not having dealt with it
>sooner) that all added up to my not saying anything when I did
>remember.
>    I can see all my back fillings and my wife can see the filling in
>the incisor.
>    I know that to be on the safe side I should make another
>appointment for a dentist to have a look but I want the general opinions
>of the dental professionals on this newsgroup about the situation...
>How hard is it to miss a missing filling?
>If it is missing and not noticible how much damage could there be?
>                                               is there likely to be?
>Other thoughts?

Shallow fillings frequently break and fracture because of the lack of
depth of the cavity preparation.  The cavity preparation needs to be
into dentin (approximately 2mm deep) to allow for adequate strength of
the filling material.  It is possible not to notice one of these
"shallow", missing fillings.  Very often, the area looks abraded and
is overlooked as normal for that patient.  If you know what tooth has
part of the filling missing, identify it for your dentist and let
him/her make the decision to restore or not restore.  Dr. Jeff W.


Wed, 27 Jan 1999 03:00:00 GMT
 Dentist missed lost filling

If it was a very small "prophylactic" amalgam, it could be overlooked,
especially if she was in a hurry.  Sometimes they leave very little trace.
 It shouldn't have been overlooked; however, there is not a dentist
practicing today that hasn't inadvertantly overlooked some small
situation..

What I'm really hearing, though, is you're not entirely pleased with this
dentist, and it's not because of the missed filling.  If you had a lot of
trust and genuinely liked this person's care and personality, a small
thing like that would not have concerned you.  So, it's always my belief
that a patient should be in an office where he/she feels well cared for in
an enjoyable, relaxed atmosphere.

Good Luck.

Grant Ritchey


writes:

Quote:
>Hi,
>    Background: I have four fillings in the
>back lower molars, these were put in about 25 years ago.  X-rays show
>them to be very shallow.  My parents weren't there and at age 10 or so
>I wasn't too clear about what was going on.  A couple of other dentists
>I have talked to seem to think they were quite possibly prophalactic
>fillings.

>    One of those fillings cracked and was replaced a year or so ago.
>Also in the last two years I developed a cavity in one of my upper
incisors
>which was filled.

>    To the best of my memory that is the extent of my dental history,
>at least as far as fillings go. (I also have a couple of horizontally
>impacted Wisdom teeth but that is another story)  Never had any braces.

>    About 5 weeks ago I lost a filling, I am a great procastinator and
>three days ago my wife surprised me by telling me I had an appointment
for
>my 6 month checkup.  I went in the next day, I was a bit late, it was
just
>before lunch.  The Dentist asked if anything was new and at that point I
>had forgotten about the missing filling.  She took an X-ray, examined,
>cleaned and polished my teeth, checking for depth of receding gumlines
>and ?mouth cancer along the way, examined my x-ray and gave me a clean
>bill of health.

>    My dentist seems competant enough, she was probably in a bit of
>a hurry.  

>    I don't particularly like her "bedside manner" and am thinking
>about changing dentists.  I also have some mixed feelings about those
>fillings in the back.  Combined with embarrassment for having forgotten
>to tell her about the missing tooth (and at not having dealt with it
>sooner) that all added up to my not saying anything when I did
>remember.

>    I can see all my back fillings and my wife can see the filling in
>the incisor.

>    I know that to be on the safe side I should make another
>appointment for a dentist to have a look but I want the general opinions
>of the dental professionals on this newsgroup about the situation...
>How hard is it to miss a missing filling?
>If it is missing and not noticible how much damage could there be?
>                                               is there likely to be?
>Other thoughts?

>Robert





Wed, 27 Jan 1999 03:00:00 GMT
 Dentist missed lost filling


<snip>

Quote:
>    About 5 weeks ago I lost a filling, I am a great procastinator and
>three days ago my wife surprised me by telling me I had an appointment for
>my 6 month checkup.  I went in the next day, I was a bit late, it was just
>before lunch.  The Dentist asked if anything was new and at that point I
>had forgotten about the missing filling.  She took an X-ray, examined,
>cleaned and polished my teeth, checking for depth of receding gumlines
>and ?mouth cancer along the way, examined my x-ray and gave me a clean
>bill of health.

<snip>

>Robert


>Real Men change diapers

--

From what you describe, some of your fillings are so shallow that they
don't go all the way through the enamel.  I've seen fillings placed this
way.  I don't understand the rational for such treatment, but perhaps it
was considered a good idea at the time.  

If you loose such a filling, not much harm has been done.  Often times the
resulting 'hole' is so shallow, it can easily be maintained with regular
brushing.  When a patient looses such a filling, I'm faced with the choice
of having them back and placing a deeper filling that will stay in place
(thin fillings have a high failure rate) or leaving the situation alone.  I
base my decision on wither or not I think the patient can maintain this
area with regular brushing habits.  I sometime opt to leave these areas
alone.  

Just because your dentist didn't say anything to you about it, doesn't mean
that she missed it.  

On the other hand, I haven't seen you, and your situation may be entirely
different.  It's impossible to say without actually seeing the case.

I don't think you should fire your dentist just on this instance.  

David E. Johnston, D.D.S.



Wed, 27 Jan 1999 03:00:00 GMT
 Dentist missed lost filling

Hi all,
        Just a note of thanks for all of your comments, thoughts and advice.
Robert


Real Men change diapers



Fri, 29 Jan 1999 03:00:00 GMT
 Dentist missed lost filling


Quote:
Jeff Weiser) writes:
>Shallow fillings frequently break and fracture because of the lack of
>depth of the cavity preparation.  The cavity preparation needs to be
>into dentin (approximately 2mm deep) to allow for adequate strength of
>the filling material.  It is possible not to notice one of these

These guidelines are for amalgam not composite.  Research shows that with
composite less tooth removal can be a better thing.

Jeff

Jeff L. Rodgers, DMD



Fri, 29 Jan 1999 03:00:00 GMT
 Dentist missed lost filling

Quote:


> Jeff Weiser) writes:

> >Shallow fillings frequently break and fracture because of the lack of
> >depth of the cavity preparation.  The cavity preparation needs to be
> >into dentin (approximately 2mm deep) to allow for adequate strength of
> >the filling material.  It is possible not to notice one of these

> These guidelines are for amalgam not composite.  Research shows that with
> composite less tooth removal can be a better thing.

> Jeff

> Jeff L. Rodgers, DMD

Very good point, Jeff.  I routinely remove much less tooth structure
to place composites than I used to when I was placing amalgam.  When I
was in dental school, I was placing a Class I on my wife (#29).  It
was a small fissure and when I had removed all of the decay, I quit.  
An instructor came over and made me deepen the prep "because it didn't
have sufficient bulk".  I am glad that I don't have to remove extra
healthy tooth structure any more.

Regards,
SWF DDS



Fri, 29 Jan 1999 03:00:00 GMT
 Dentist missed lost filling
Quote:

> Hi,
>    Background: I have four fillings in the
> back lower molars, these were put in about 25 years ago.  X-rays show
> them to be very shallow.  My parents weren't there and at age 10 or so
> I wasn't too clear about what was going on.  A couple of other dentists
> I have talked to seem to think they were quite possibly prophalactic
> fillings.

>    One of those fillings cracked and was replaced a year or so ago.
> Also in the last two years I developed a cavity in one of my upper incisors
> which was filled.

>    To the best of my memory that is the extent of my dental history,
> at least as far as fillings go. (I also have a couple of horizontally
> impacted Wisdom teeth but that is another story)  Never had any braces.

>    About 5 weeks ago I lost a filling, I am a great procastinator and
> three days ago my wife surprised me by telling me I had an appointment for
> my 6 month checkup.  I went in the next day, I was a bit late, it was just
> before lunch.  The Dentist asked if anything was new and at that point I
> had forgotten about the missing filling.  She took an X-ray, examined,
> cleaned and polished my teeth, checking for depth of receding gumlines
> and ?mouth cancer along the way, examined my x-ray and gave me a clean
> bill of health.

>    My dentist seems competant enough, she was probably in a bit of
> a hurry.  

>    I don't particularly like her "bedside manner" and am thinking
> about changing dentists.  I also have some mixed feelings about those
> fillings in the back.  Combined with embarrassment for having forgotten
> to tell her about the missing tooth (and at not having dealt with it
> sooner) that all added up to my not saying anything when I did
> remember.

>    I can see all my back fillings and my wife can see the filling in
> the incisor.

>    I know that to be on the safe side I should make another
> appointment for a dentist to have a look but I want the general opinions
> of the dental professionals on this newsgroup about the situation...
> How hard is it to miss a missing filling?
> If it is missing and not noticible how much damage could there be?
>                                               is there likely to be?
> Other thoughts?

> Robert


> Real Men change diapers



Sat, 30 Jan 1999 03:00:00 GMT
 Dentist missed lost filling

Quote:

>Hi,
>    Background: I have four fillings in the
>back lower molars, these were put in about 25 years ago.  X-rays show
>them to be very shallow.  My parents weren't there and at age 10 or so
>I wasn't too clear about what was going on.  A couple of other dentists
>I have talked to seem to think they were quite possibly prophalactic
>fillings.

I have seen a few of these "prophylactic" restorations over the years,
always was amazed they stayed in as well as they did, seeing as how
they barely penetrated the enamel in many cases, as viewed on X-rays.

Quote:
>    About 5 weeks ago I lost a filling, I am a great procastinator and
>three days ago my wife surprised me by telling me I had an appointment for
>my 6 month checkup.  I went in the next day, I was a bit late, it was just

Well, this is a chronic problem experienced in dental offices. Most
places I know stay on time fairly well, and if we get behind, it's
usually due to patients showing up late. I'm not trying to be critical
here,  just stating my "world view" as a dentist (grin). I'm probably
biased.

Quote:
>before lunch.  The Dentist asked if anything was new and at that point I
>had forgotten about the missing filling.  She took an X-ray, examined,
>cleaned and polished my teeth, checking for depth of receding gumlines
>and ?mouth cancer along the way, examined my x-ray and gave me a clean
>bill of health.
>    My dentist seems competant enough, she was probably in a bit of
>a hurry.  
>    I don't particularly like her "bedside manner" and am thinking
>about changing dentists.  I also have some mixed feelings about those
>fillings in the back.  Combined with embarrassment for having forgotten
>to tell her about the missing tooth (and at not having dealt with it
>sooner) that all added up to my not saying anything when I did
>remember.
>    I can see all my back fillings and my wife can see the filling in
>the incisor.
>    I know that to be on the safe side I should make another
>appointment for a dentist to have a look but I want the general opinions
>of the dental professionals on this newsgroup about the situation...
>How hard is it to miss a missing filling?
>If it is missing and not noticible how much damage could there be?
>                                               is there likely to be?
>Other thoughts?
>Robert

>Real Men change diapers

BTW, love your tagline! You pretty well have a handle on the
situation.  Some of these "prophylactic" fillings are so damned
shallow, I've only noticed something wrong because only a fragment of
the filling was left. The rest of the "tooth preparation" was so
shallow, I wasn't sure if I was looking at normal wear, or what.
Obviously the tooth has not been sensitive, and assuming the dentist
in question  "explored" (picked at your teeth) for cavities and found
none, then, quite frankly, I wouldn't get worked up in a lather over
it. If you don't care for this particular dentist, you certainly have
the right to change.  For the most part the exam seemed fairly
thorough, and although I know my colleagues here on the "net" never
miss anything (grin), after all, we dentists are human, and
occasionally things get overlooked. On the plus side, usually the
overlooked things are pretty damned inconsequential as a rule, and if
it's something serious, it will be obvious by next check-up time.  (I
perhaps should have worded this differently, but it's late, I'm tired,
and I'll enjoy the flames the next time I sign on, giggle)

Gregory A. Thompson, D.D.S.
Sysop, Open Wide Communications Hotline (O.W.C.H.) BBS
(816) 358-6254 8,N,1 1200-14,400 bps, Open 24 hours...
"Call me!"



Mon, 08 Feb 1999 03:00:00 GMT
 Dentist missed lost filling


Big snip

Quote:
>Some of these "prophylactic" fillings are so damned
>shallow, I've only noticed something wrong because only a fragment of
>the filling was left. The rest of the "tooth preparation" was so
>shallow, I wasn't sure if I was looking at normal wear, or what.
>Obviously the tooth has not been sensitive, and assuming the dentist
>in question  "explored" (picked at your teeth) for cavities and found
>none, then, quite frankly, I wouldn't get worked up in a lather over
>it. If you don't care for this particular dentist, you certainly have
>the right to change.  For the most part the exam seemed fairly
>thorough, and although I know my colleagues here on the "net" never
>miss anything (grin), after all, we dentists are human, and
>occasionally things get overlooked. On the plus side, usually the
>overlooked things are pretty damned inconsequential as a rule, and if
>it's something serious, it will be obvious by next check-up time.  (I
>perhaps should have worded this differently, but it's late, I'm tired,
>and I'll enjoy the flames the next time I sign on, giggle)
>Gregory A. Thompson, D.D.S.
>Sysop, Open Wide Communications Hotline (O.W.C.H.) BBS
>(816) 358-6254 8,N,1 1200-14,400 bps, Open 24 hours...
>"Call me!"


I agree. It fact, even when I do see a lost "prophylactic" filling, I
tell the patient I'm going to ignore it. The prepared tooth rarely has
any grooves to catch food, debris, etc. and are too shallow to
adequately fill.

James S. Eaves, D.D.S.



Sat, 13 Feb 1999 03:00:00 GMT
 
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