We often talk to patients and parents about “watch areas”. It is important to understand that a "watch" is truly a cavity. Bonafide, real, and documented visually or with x-ray. The reason I am “watching” it rather than filling it is that current knowledge provides a reasonable opportunity to stop the progress of the decay with proper daily preventive care. There is even the possibility of reversing the decay process to the point that the lesion will disappear on subsequent x-rays. The cavity would be “healed”.
Clearly, reversing a cavity, or even stopping a cavity that has already started, will take greater diligence than what has allowed the cavities to start. This begins with better cleaning routines. The huge majority of these watch areas must be cleaned with floss every day. If that is not happening, the decay causing bacteria will eventually win and the cavity will grow, eventually necessitating a filling. Additionally, the decay causing bacteria will be starting other cavities in new places. Therefore, floss floss floss!
Remineralizing, or ‘healing’ the cavity, takes more than just keeping it clean. Fluoride is the best remineralizing tool we have. The reports on fluoride research over the last 20 years clearly indicate the primary action of fluoride occurs topically on the teeth. We don’t have to swallow the fluoride. Therefore topically applied agents like toothpaste, fluoride rinses, prescription home fluoride treatments, and professionally applied fluorides are what works best. If your risk for getting cavities is high, you will want to use these products wisely.
Toothpaste with fluoride is a great start. Brush twice a day. Be sure to spit out the toothpaste thoroughly. For young children who are likely to swallow the toothpaste, please use a 'pea size’ amount of toothpaste on the brush. Don’t rinse after the brushing; just spit well. Leave that residue of toothpaste on the teeth. The fluoride residue will continue to interact with the surface enamel.
Use a fluoride rinse once daily. Please do this when nothing will be eaten or drunk after the rinse. The best time is just before bed since the saliva flow slows down during sleep and the fluoride residue will dilute slower and have a better effect.
For children under 6, who are likely to swallow a rinse, we recommend instead a prescription fluoride toothpaste. You apply it once daily after brushing. We will instruct you with this product if it is recommended for your child.
Please remember. Watch areas are real cavities in progress. If they are not cared for diligently, they will do what all cavities do. They will get larger and need treatment.