Expert: Zev Kaufman, D.D.S. - 2/21/2009

Question
I just went to the dentist to have my teeth clean. He said I have no cavities.
He said I just have some pockets. I was not thinking at the time to ask him
what the pockets mean. When I got home I noticed that I had some small
black dots on the top of two of my back teeth. I also noticed some on the top
right back teeth. They are small and they do not hurt at all. What is it. Can
these areas be prone to cavities?

Answer
Dear Jessica:
The answer is: Yes.  The black dots on the tops of the teeth can be the beginning of tooth decay.  However, it could just be staining and have no consequence.  I am more concerned of the fact that your dentist told you that you have pockets and treatment of them was not discussed.   Periodontal probing (pockets) are indication of early stages of periodontal disease and should be addressed by proper oral hygiene instructions for your home care and proper dental treatment, either by your general dentist or a referral to a Periodontist.
I suggest that you do the following in the following order:
1.  Speak to your dentist and ask about the black stains (since only physical examination can tell you if the stains are cavities).  Also ask the dentist about the pockets and whether he wants to refer you to a Periodontist.
2.  If your dentist does not answer your questions adequately, go to www.prosthodontics.org and locate a Prosthodontist (the specialist in restorative, cosmetic, and implant dentistry) in your area.  Go for a second opinion.  The Prosthodontist will determine if you have tooth decay and if you need to be referred to a Periodontist to treat the pockets.
3.  If a Prosthodontist is not available, go to www.perio.org and locate a Periodontist (the specialist in gum diseases) in your area.  Have the Periodontist evaluate your mouth and advise about the black dots as well.
4.  If the specialists are not available, try and locate another, reputable general dentist, or go to a local dental school, or a hospital based dental residency for an, unbiased, second opinion.

Have a great weekend and best wishes,
Dr. Zev Kaufman