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The wife and I have been going to the same dentist for about 3 years. It seems like clockwork that every other visit they find 1-2 cavities for each of us (meaning once a year they find this). We're starting to find it a bit interesting since we've as we've never had more cavities than when we started going to this office. As a reference, I had never had a cavity before and the wife has only had 2 before. We're both early thirties.

Every dentist has his threshold for what he deems a watchable lesion and what needs to be filled. I truly believe that the best dentistry is the least dentistry and I use that philosophy to guide my diagnosis as well as xrays, explorer (to check the pits and fissures and to check the feel of the enamel), the patient's oral hygiene and what medications the patient takes and foods/drinks that they eat.

For example, a new patient that hasn't been to the dentist in years and has poor oral hygiene and diet, will get treated more aggressively than someone who has good oral hygiene and diet. A patient that has a high caries rate as evidenced by the number of fillings and crowns in their mouth would also be treated likewise.

I often see patients that are middle aged and a few previous fillings with a sticky groove in one molar tooth. If it is a new patient to me, I would probably not fill it, since it has obviously been there for quite some time and hasn't progressed. Remember, the best dentistry is the least dentistry.

I just saw a new patient, mid thirties, that had been diagnosed with needing several cavities filled. When I examined him, I saw that he had a couple of shallow filling placed recently in two adjacent molars. When I examined the rest of the teeth, I saw a few deep narrow grooves, but none that needed to be filled since he had good hygiene, no meds, a decent diet and low caries incidence. He was sure that he had some fillings that had been previously diagnosed by his former dentist and was surprised that I didn't find anything. He asked me if his former dentist had scammed him and I explained my philosophy and not wanting to throw anyone under the bus told him that maybe our philosophies differed.

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Any opinions on over diagnosing cavities? They mentioned they were being "conservative" on their approach, but I can't imagine getting one to two fillings a year for the next 30 years....

Over diagnosing does happen, but I believe that it is less common than some would believe. If you are the least bit suspicious of the diagnosis you receive, by all means get a second or even third opinion. Most dentists will offer a free consult for a second opinion, as it is a chance to build good will and get to meet a new, possibly long term, patient.

Good luck.