Dental Decay Treatment

How do you detect decay in initial stages?

The dentist can detect initial decay by examination of the teeth and by taking an X-ray. Usually decay in between teeth can be spotted on a bitewing X-ray and on the grinding surface by probing these areas.

Do' black spots' on the teeth indicate decay?

Grooves and pits on the grinding surfaces easily get stained by food stuffs and beverages Hence all black spots are not decay and only black spots which have softened the tooth are the areas of decay .The detection should be done by a dentist.

How do you identify decay between teeth?

Initial decay/ caries between teeth can be spotted on bitewing X-rays. In later stages, when more destruction takes place food usually gets impacted between teeth. A dental checkup will confirm the detection.

What are the areas of tooth prone for decay?

The grinding surface of teeth usually has many grooves and pits and is therefore prone for accumulation of food and microorganisms. Thus the grinding surface of the back teeth shows high incidence of dental decay. In addition the area around the contact between the teeth, is also the starting point of decay. Other areas of decay are the pits found on the outer surface of the molars and small pits on the inner side of the upper front teeth.

Does decay occur in old age?

Yes, it does but less frequently and is commonly seen on the exposed part of the root. Advancing age usually results in recession of the gums resulting in exposure of the root surfaces of the teeth. Food and plaque easily accumulates around these areas leading to decay if the oral hygiene is poor

Does an abscessed tooth need to be removed?

Dental abscess is the extension of infection from the tooth to the underlying bone. Once, active infection is controlled by antibiotics, the tooth is treated by special procedure called root canal filling. This helps the tooth to be retained in position and function normally.

Is it true that raw vegetables & fibrous food lower the chances of decay.

Refined form of food easily sticks in and around the teeth and enhance formation of dental plaque whereas eating fibrous food helps in cleansing the teeth during chewing. Decay is more frequently seen in urban people who eat more refined foods and hence is known as a of disease of modern civilization.

How does fluoride prevent decay?

Fluorides have the ability to get incorporated into the tooth structure and make the teeth more resistant to dental decay. The use of fluorides may even arrest progression of caries which are in the initial stages. Fluoride when consumed during formation of teeth gets incorporated in the tooth structure and makes the enamel stronger. It also has an anti -bacterial effect on several germs that cause decay and makes dental plaque difficult to attach to the tooth.

Is it true that some type of chewing gums help prevent decay?

Yes, only sugar free chewing gums containing xylitol has shown promising results in reducing decay, while others that contain sugar do not help.

When is it appropriate to fill a cavity?

Although cavities in teeth need not be treated as an emergency, (unless associated with an abscess), they should be filled as early as possible since, decay is a slow progressive process and without many symptoms until the tooth is grossly destroyed. Sometimes even a small spot may show massive destruction below it. Treating the decay at the intial stage helps conserve tooth structure.

Is any tooth resistant to decay?

No, but usually lower incisors, canines and upper canines are least prone. The first permanent molars are most commonly affected by caries as their grinding surface is often full of deep pits and grooves that tend to accumulate food and microorganisms. In addition the first permanent molars erupt early at a time when the oral hygiene of children is poor. Proper, regular tooth brushing with fluoride containing tooth pastes can help to make the tooth more resistant to decay.

Do all cavities on tooth cause pain?

The pulp of the tooth contains the nerve endings and blood vessels and is protected by the outer enamel and dentin layer. Shallow cavities at the depth of enamel and the surface of dentin are painless. As the depth of the cavity increases in dentin the tooth becomes painful on eating hot, cold, sour or sweet foods. Once the decay reaches pulp the pain is intolerable.

Can a badly decayed tooth be saved?

If sufficient sound tooth structure remains, then the tooth can be saved by covering the whole tooth with a metal crown / cap. A dentist specialized in crown and bridge prostheses will be the best person to treat such teeth.

Can a filled or restored tooth get decayed?

Yes, even a cavity filled with a permanent filling can develop dental caries below the filling. Hence, better care by brushing, flossing the restored tooth along with routine checkup will enhance the long-term success.

Does regular brushing keep decay away?

Yes to a great extent, since it controls the formation of dental plaque that predisposes to decay. However, other factors like deep grooves and pits on the grinding surface of teeth, weak teeth with less calcium content can make them more susceptible to decay

Can a filling last lifetime?

A well done permanent filling, with proper maintenance by the patient usually lasts 20-25 years or more.

What is silver filling?

Pure silver is mixed with several other metals like copper, tin and mercury to make it into a semisolid form that is packed into the cavity and then allowed to harden. It has been used in dentistry for over 100 years and does function well in the mouth. This type of restorative material is called silver amalgam.

Is the mercury present in the silver filling poisonous?

No, the mercury when mixed with silver alloy reacts and forms various compounds and only tiny traces are left in the filling. Studies have shown that this tiny trace of free mercury does not leach out and is not harmful to the body.

Why do silver filling appear grey/ black in colour?

The surface of the silver filling needs to be polished once it is set. Once it is polished the shine of silver is seen. However, most dentists do not do this and hence it appears grey in colour.

Do silver fillings fracture during the course of usage?

Although they are considered permanent they may fracture in some instances. Fillings that are large in size or old can fracture over a period of time due to heavy biting force. Hence regular monitoring by the patient and check up by the dentist is necessary for long term success.

Can you fill a cavity with a material that is the same colour as the tooth?

Filling materials are available that are similar in color to tooth colour. These are thus very esthetic in appearance and match the color of the teeth. These filling materials are called composites.

Is silver filling better or Tooth color filling?

Silver fillings have been done for about a 100 years with good success. Cavities filled with silver amalgam last more than 30 years. Now there are few reports of amalgam toxicity leading to systemic problems. Moreover silver appears black. So Composite filling which appears like the tooth is preferred. Composite bonds to the tooth and hence durable. Marginal leakage can occur, hence regular check up is necessary to asses the health of the filling.

Can a permanently filled tooth get damaged?

Yes fillings can get damaged or can fracture. Most filling materials do not bond with the structure of the tooth. Hence a small micro gap may exist between the tooth and the filling. These micro-gaps tend to transport food and microorganisms into the deeper regions of the tooth below the filling and thus once again initiate dental decay deep inside. Thus extra care should be taken to maintain hygiene around restorations.

Can a filled or restored tooth get decay?

Yes, a filled tooth is more susceptible to dental decay than a normal tooth. Hence, better care in the form of brushing and flossing and routine checkup can enhance the long-term success of the restoration.

Can you fill a cavity without drilling the tooth?

A drill is used to clean and remove all the infected (decayed) areas of tooth and create a box like cavity. This ensures that the filling material can be easily stuffed into the cavity and stays inside. Today's high speed drills do not cause much vibration and run at very high speed unlike the slow speed drills of yester years and thus are more comfortable for the patient.

Do deep cavities require any additional treatment?

Cavities that are too close to the pulp require medicated restoration for a period of time which will allow the pulp to recover from attack of germs and toxins and helps to form a protective barrier around the affected area. Once this is formed the tooth can receive a routine filling

How is sensitivity treated?

In initial stages, protective desensitization tooth pastes that are commercially available are useful. They have to be applied for a long period of time to get adequate relief. If erosion/abrasion/cavity is noticed they have to be filled and in severe cases, protection with metal caps may be necessary.

What causes sensitivity?

This may occur either due to tooth-decay or to wrong brushing habits - leading to enamel getting lost from that area and exposing the underlying dentin. Another important cause of sensitivity is trauma to the tooth - if any tooth is constantly being traumatized due to bite problems or improper occlusion then that tooth is likely to become sensitive.

People who tend to consume a lot of aerated drinks (sodas) may also have sensitive teeth. The acid in the drink tends to wear off the enamel and then the underlying dentin gets exposed to the environment, causing sensitivity.

Bad oral hygiene that can cause severe gum infections can also present as sensitivity. This is due to the irritation caused by the infection of the gums at the root surface of the tooth.

Can it just be treated by desensitizing pastes?

No. The cause has to rectified. Sensitivity due to Cavities may be an initial symptom and have to filled to be filled before they spread to the pulp.

What are stains caused by?

The surface stains are usually dark brown and are caused by such strong discolouring agents as coffee, tea, or tobacco. They occur mostly between your teeth and on the surfaces of crooked teeth.

Why is there a change in color of teeth?

The change in color  are incorporated into basic tooth structure through faulty hardening of the tooth before birth, or the interruption of normal enamel formation by medication or disease. These types of stains may include white patches on the enamel surface or bands of brownish grey colours across the tooth. These stains are caused due to intake of tetracycline by mother or during early childhood, increased amount of Fluoride in ground water, childhood diseases and some hereditary diseases. Trauma can cause the tooth to loose its vitality and can change color to various shades of brown to black. These stains are permanently locked into your tooth and cannot be removed inspite of hard brushing or harsh abrasives.

Is bleaching permanent?

Bleaching is not permanent. It may have to be repeated to maintain the colour of teeth.

Is bleaching safe?

Bleaching done under professional care is safe.

How does the color change while bleaching?

Superficial layer of enamel is microetched to remove the stains.

Are there any side effects of bleaching?

Possible side effects include increased sensitivity to cold during the treatment, tongue and lip soreness, and possibly throat irritation. These side effects always resolve in one to three days after completion or interruption of treatment.

Can bleaching done to all patients?

It is necessary to have a healthy mouth before beginning to whiten your teeth. Bleeding gums, cavities, sensitive teeth, and other conditions must first be treated. The teeth must be cleaned and polished, to ensure that the whitening gel comes into direct contact with the teeth.

What are causes of dull color of teeth?

The color of teeth varies from person to person. Our teeth yellow with age because the enamel looses its translucency. Coffee, tea, cola drinks, soya sauce, cigarettes, pan, tobacco, food colouring, etc. will hasten this process. Many parents remark that the milk teeth of their child were whiter than the permanent teeth that have taken their place - how true! Permanent teeth are yellowier than milk teeth, and tend to get darker with age.

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