DENTAL CAVITIES - Dr. Jigisha
What Are Dental Cavities？
Dental cavities or dental caries is a microbiological disease of the tooth and is characterized by demineralization of calcified substance and destruction of the organic portion of the tooth structure. Our tooth is composed of three layers, the outer layer which is the enamel, the middle layer, dentine, and the innermost layer which consists of nerve and vessels, the pulp.
Dental caries starts with the breakdown of enamel and then moves further till it reaches the pulp and infects the entire tooth.
What Causes Dental Cavities?
The oral cavity is host to several bacteria; some of these bacteria are responsible for causing dental cavities. The bacteria form a biofilm on the tooth structure which matures to form plaque and further calcifies to form dental calculus which is adherent to the gums and the tooth. Dental calculus harbors these disease-causing bacteria. The bacteria metabolize sugars from the food we eat. These bacteria release acidic substances and other noxious by-products that attack the enamel and break it down leading to dental caries. If not treated at this stage, the infection progresses further involving the dentin and finally the pulp which leads to intense pain.
The risk for dental caries is higher in the following conditions-
- Poor oral hygiene
- Misaligned teeth act as a hiding spot for bacteria and are difficult to keep clean.
- Diet rich in sugary drinks, sticky food substances that adhere to the tooth structure and provide a niche to the bacteria
- Not consuming enough fibers in the diet and not drinking enough water.
- Dry mouth
- Poor immunity
Symptoms of Dental Cavities
- Toothache during any time of the day without a particular reason.
- Toothache that increases during consumption of sweet, hot, and cold food or beverages.
- Tooth pain on biting down
- White spots or brownish-black discoloration of teeth
- Holes in the teeth
- Food lodgement
Treatment for Dental Caries
Treatment for dental caries varies according to the extent to which the infection has progressed.
- Dental restoration
Dental fillings or dental restorations can be used to restore a decayed tooth when the cavity is limited to enamel and dentine. The carious part is removed using a dental drill and restored mimicking its anatomical form using dental cement or dental resins.
- Indirect pulp capping
The indirect pulp capping is done when the dental cavity is deep and has reached near the pulp but not invaded it. Calcium hydroxide is used which seals the defect and then the cavity is restored by using dental cement or resins.
- Direct pulp capping
Your dentist may choose to opt for a more conservative approach when there is pinpoint exposure of the dental pulp. Again, calcium hydroxide is placed on the defect to stop bleeding and wall off the defect. It is then restored normally.
- Root canal treatment
Root canal treatment becomes the treatment of choice when there is extensive decay involving the pulp, in presence of a periapical infection or an abscess. The tooth is opened, the affected area drained and cleaned out. The canal is then restored with gutta-percha or other available root filling materials. Once the root is filled the crown portion of the tooth is restored.
- Dental crowns
Often, dental cavities destroy the bulk of the tooth structure, it is at this point where the tooth becomes weak and the function is compromised. In such cases, it becomes important to restore the shape, size, and length of the tooth. A dental crown restores the functioning of the tooth by restoring the tooth to its original shape, this helps the tooth to bear the brunt of mastication forces and maintain aesthetics. There are a wide variety of crowns available, like metal, porcelain, metal fused to porcelain depending on individual needs.
Extraction is the last resort available. When there is extensive destruction of tooth structure or the infection has involved the peripheral structures, we have no choice but to extract the tooth. After extraction and once the wound heals, we can restore it by using a removable or fixed partial denture or dental implants.
The more extensive the decay, the more aggressive the treatment. Therefore it is of prime importance to diagnose and treat dental cavities to avoid losing your teeth. Even one lost tooth can disturb the entire oral harmony. Therefore it is essential to go for a regular dental visit to ensure healthy oral and overall health.
--- By Dr. Jigisha I Graduated Bachelors in Dental Surgery from the Maharashtra University of Health Sciences, India, she is a dental surgeon from the central Indian city of Nagpur.