Deep Cavities: Why You Might Not Feel Pain

Cavity issues?

Hello Doctor, my upper right molar (the last tooth but not the wisdom tooth) has a cavity.
It was filled two years ago, but recently the white filling came out.
However, I don't feel any sensitivity or pain at all.
The doctor refilled it and mentioned that the cavity is quite deep, and if I experience pain, I would need a root canal.
After the filling, I can tap it without pain, bite into things without discomfort, and drink hot or cold water without any sensitivity.
The only time I feel pain is occasionally when I swallow and my tongue touches it.
Why is it that I have a deep cavity but don't feel pain? I've heard that cavities can continue to develop under fillings, so will I experience pain later? How long can the white filling, which is like resin, last, and is it prone to damage? I brush my teeth for three minutes with a sensitivity toothpaste and use mouthwash (I rinse immediately after eating).
Is this effective in preventing cavities? Currently, I am wearing braces; does this increase my risk of cavities? Thank you, Doctor.

Yu Jun, 10~19 year old female. Ask Date: 2016/04/21

Dr. Zeng Guanghui reply Dentistry

1.
Deep cavities that do not cause pain may be due to the filling material blocking further bacterial invasion of the carious lesion, or it is possible that the dental nerve has already died.
2.
If a filled cavity is properly maintained with good oral hygiene, the risk of secondary cavities and pain will be reduced.
3.
Resin fillings for cavities can last a long time if the occlusal force is normal, and if the patient avoids grinding their teeth or frequently consuming acidic foods.
4.
Maintaining meticulous oral hygiene can prevent cavities; this is especially important for individuals wearing braces, as they need to be more diligent while brushing to avoid plaque accumulation, which can lead to cavities.

Reply Date: 2016/04/21

More Info

When it comes to dental health, particularly regarding cavities and their associated pain, it's important to understand the underlying mechanisms of tooth decay and the body's response to it. In your case, you mentioned having a deep cavity in your upper right molar that was previously filled but has since lost its filling. Despite the depth of the cavity, you are not experiencing significant pain, which can be puzzling.

Firstly, it's essential to recognize that not all cavities cause pain. The nerve endings in teeth can react differently based on various factors, including the extent of decay and the proximity of the cavity to the dental pulp, which houses the nerves and blood vessels. If the decay has not yet reached the pulp, you may not feel pain, even if the cavity is deep. This is why some individuals can have significant decay without immediate discomfort. However, as the decay progresses and approaches the pulp, the likelihood of experiencing pain increases, often leading to symptoms such as sensitivity to temperature changes or pain when biting down.

You also mentioned that your dentist indicated the possibility of needing a root canal if the tooth continues to decay. This is a common procedure when the decay has reached the pulp, as it involves removing the infected tissue and sealing the tooth to prevent further issues. It's crucial to monitor your tooth closely; if you start to experience pain, it could indicate that the decay has progressed.

Regarding the material used for your filling, modern dental composites (often referred to as resin) are durable but can wear down over time. The longevity of a filling can depend on various factors, including the location of the filling, your oral hygiene practices, and your dietary habits. Regular dental check-ups are essential to assess the condition of your fillings and to catch any new decay early.

Your oral hygiene routine, which includes using fluoride toothpaste and rinsing after meals, is a proactive approach to preventing cavities. Fluoride helps to remineralize enamel and can reverse early signs of decay. However, it's also important to maintain a balanced diet and limit sugary snacks, as these can contribute to the formation of cavities.

As for wearing braces, it can indeed make maintaining oral hygiene more challenging, which may increase the risk of cavities. Braces can trap food particles and plaque, so it's crucial to brush and floss diligently. Your orthodontist can provide specific recommendations on how to care for your teeth while wearing braces to minimize the risk of decay.

In summary, while it's possible to have a deep cavity without pain, it's essential to stay vigilant about your dental health. Regular visits to your dentist, maintaining good oral hygiene, and being aware of any changes in your tooth's condition will help you manage your dental health effectively. If you experience any new symptoms or changes, don't hesitate to reach out to your dentist for further evaluation.

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