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Black spots on teeth

There used to be a big dilemma for the dentists whether to fill all those teeth with black spots or black lines. We see all sorts of patients with different educational backgrounds. No doubts dentists make all efforts to convince the patients that all those black spots and black lines don’t require fillings (restorations).

But some patients are indeed quite difficult. Howsoever, you may try to convince some of patients, they appear determined to get “unnecessary “fillings. They would keep on changing the dentists they get a “friendly one” who would “agree” with them.

During my career, I have noticed that this is indeed a big problem. When they visit a dentist, even before an oral examination by the dentist, they declare that they need some dental fillings(restrorations). Once upon a time, dentistry used to be “drill and fill” type.

Now that our knowledge about the cause of dental diseases and their treatment has improved very much, now we always follow a wait and watch policy. We are least inclined to fill all those black lines and black spots.

Reason for not filling ? — it is because of the reason that many of such carious lesions are just incipient lesions which hardly require fillings. Many such lesions are arrested carious lesions- it means that those are no longer active carious lesions and there is no point in drilling and filling those silent, arrested, incipient lesions.

The dentistry has progressed so much – there have been so many advancements in the field of dental materials, dental creams etc that now we have the understanding to repair the incipient carious lesions with the use of dental materials and more importantly with the great role being played by fluouridated dental pastes. Patient needs to be made aware about this new possibility.

And secondly, emphasis needs to be laid on the regular periodic check-ups so that anytime we find we find that those innocuous, incipient caries lesions are progressing, we can immediately restore these —-yeah, nipping the evil in the bud. The important point to be remembered is that whenever there is catch on the tooth surface – our dental probe gets stuck deep into a tooth surface or patient complains of food impaction in a cavity, then those cavities are better filled.

Otherwise, prevention of cavities as we all know is the best. Afterall, howsoever great progress we have made in filling materials and techniques, these all are afterall poor alternatives to the natural tooth structures — Mother Nature’s priceless gift – and all our efforts need to be directed towards preservation . One thing I would like to add that decades ago, the dentists used to drill quite big holes for fillings which is no longer necessary — just small holes, deep enough to hold the filling. Now-a-days we have fillings which chemically unite with the tooth structure rather than mechanical “locking” of the fillings which used to be hallmark of fillings 50-60years ago.
Please take care of these 32 pearls!