Yonsei U-Line Dental Clinic - Are There Cavities Even Dentists Can Easily Miss?

Hello, I’m Kang Dong-ho,

Director of Yonsei U-Line Dental Clinic, Sillim Branch.

Today, I’d like to honestly talk about a situation I encounter very often during consultations.

It is known as an “interproximal cavity”—in other words, a cavity that develops between two teeth.

Why are interproximal cavities difficult to detect?

When you visit the dentist, you will generally have a panoramic X-ray taken.

It is the wide image that allows us to see all of your teeth at once.

In principle, interproximal cavities should be detectable on a panoramic X-ray.

In reality, however, they are missed fairly often.

There are several reasons.

① They are barely visible to the naked eye

If the inside of the mouth is examined visually without an X-ray, interproximal cavities are very difficult to detect.

Unless the cavity has progressed to the point where there is a clearly noticeable color change, it can be difficult even for a dentist to identify by sight.

② They can still be missed even after an X-ray

Even when a panoramic X-ray is taken, a cavity can be hidden depending on the angle or image quality.

In particular, teeth next to prosthetic restorations, such as crowns or bridges, may appear overlapped by bright white areas, making a cavity behind them difficult to see.

③ Many people are reluctant to have additional images taken

Many people ask, “Why do you need to take another one?”

Even when there is a suspicious area, if a patient feels uncomfortable having an additional X-ray taken, it may be missed during the examination.

So how can they be detected more reliably?

To properly identify interproximal cavities, small X-rays taken individually between the teeth are needed.

When people who are preparing to live abroad visit and say, “Please check everything thoroughly,” we take images using this method.

In those cases, detection is much easier.

In fact, the greater concern is often not finding the cavities, but whether all the treatment can be completed before they leave the country.

We found a cavity… Does it really need to be treated?

This is another dilemma.

If an interproximal cavity has progressed to a certain degree, treatment is naturally necessary, but the situation may be different if it is still in its early stages.

I use the following criteria based on age group.

People in their teens and 20s: I actively recommend treatment even for early-stage cavities.

People in their 30s and 40s: I decide between follow-up monitoring and treatment after assessing how far the cavity has progressed.

I also consider the follow-up interval extremely important.

For example, let’s say a woman in her late 20s visits. She takes relatively good care of her oral health, but several early-stage interproximal cavities appear on her X-rays.

The first thing I ask in this situation is, “When will you be able to come back?”

If she can return within six months to one year → It is reasonable to monitor the progression and decide later.

If she plans to stay abroad and cannot return for five years or more → It is much safer to have treatment now.

The timing of the next follow-up is therefore an important factor in deciding whether to treat an early-stage cavity.

To summarize:

※ Early-stage interproximal cavity + able to return within six months Compare images after six months and then decide.

※ Early-stage interproximal cavity + unable to return for an extended period Treatment is recommended now.

※ Cavity that has progressed to a certain degree Treatment is recommended regardless of age.

※ Early-stage cavity in people in their teens and 20s Treatment is recommended.

Early detection is key with interproximal cavities.

By not postponing regular checkups and not feeling overly burdened when an X-ray is recommended, you can detect them much earlier.

This has been Yonsei U-Line Dental Clinic.