I have no pain so there is nothing wrong with my teeth …… Bad Mistake!

I have no pain so I can be confident that there are no problems with my teeth!

It is very tempting to take this view when it comes to dental problems. However teeth don’t behave like other parts of your body. Often there is no pain associated with dental disease until the problem is very advanced. This is true of both common dental diseses tooth decay [caries ] and gum disease [periodontitis].



This x ray shows a tooth which will soon cause pain
This x ray shows a tooth which will soon cause pain

X rays are very important

These X rays are the type that dentists take to check teeth even when thereis no obvious cause for concern. They are called bitewings and we generally suggest that they should be taken ,one on each side, every two years or so. Bitewings are valuable because  they enable us to see what is going on under the enamel and between teeth.
Can you pick the problem tooth on this X ray? It is the second tooth from the left on the lower. It has an area of deep decay which will start to cause pain very soon. However this was not visible in the mouth ,and the tooth had only become a bit sensitive to cold in the last couple of weeks.
It is fortunate that the owner of this tooth did not wait for it to get worse or hope that it would go away. It had been five years since his last check up. He wisely decided to heed the warning sign and make an appointment.



Pain happens when the decay gets close to the nerve
Pain happens when the decay gets close to the nerve

What happens when a tooth becomes carious?

This tooth had become sensitive which means that the dental pulp [what we tend to call the nerve] had become irritated and inflamed . This is because the decay causing bacteria had already infiltrated deep into the tooth.
To understand how we treat a cavity like this it is neccesary to know what happens when a tooth becomes decayed or more correctly,carious. The mineral contant of the tooth is leached away and the tooth changes from being hard and bone like to being soft and spongy. When we treat this tooth we very carefully scoop out the decayed tooth structure. We then seal the surface and replace the missing tooth with a tooth coloured filling material to restore the correct shape.

What happens in the future?

Hopefully this will be all that is needed and the filling will last a long time. However, there is a very real possibility that the pulp/nerve is already irreversibly damaged. If this is the case then the tooth will become painful in the future. If this were to happen then it would either need to be extracted.Alternatively it could be saved with a root canal therapy and a crown.

This would be expensive and would compromise the tooth in the long term.

Prevention is always better and cheaper than cure.