Issues related to dental caries?
Hello, Doctor.
I have some questions I would like to ask you.
1.
I previously discovered cavities during a health check-up, so I have already seen a dentist twice and had six fillings (left upper: second premolar, first and second molars; right upper: first and second molars; right lower: uncertain).
After the fillings, I noticed that the outer sides of the second molars on both upper sides have severe decay, almost completely missing on the sides.
During my third visit, the dentist tapped on the tooth, and I indicated that it didn't hurt, so the dentist said no treatment was necessary.
Is this situation something that should be addressed only when it becomes painful, or can it heal on its own (tooth remineralization)?
2.
Following up on question 1, is the theory of remineralization correct? Do teeth have self-repair capabilities? What methods can promote remineralization?
3.
If the tooth is already painful (currently, it only hurts when I bite down hard), is root canal treatment the only option?
Thank you for taking the time to read this.
Shui Ye, 10~19 year old female. Ask Date: 2018/11/03
Dr. Huang Tingfang reply Dentistry
Dear Mr.
Shuiye,
Hello!
1.
I have filled six teeth: the upper left second premolar, first and second molars, and the upper right first and second molars.
Therefore, both upper second molars have been filled! If there are still cavities, they need to be filled to prevent further decay!
2.
If there is only discoloration or minor decay, a high-concentration fluoride gel can be applied to promote remineralization!
3.
If the tooth is already painful (currently causing sensitivity only when biting down), root canal treatment is the only option! Please communicate more with your dentist!
Thank you! Wishing you peace!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry
Reply Date: 2018/11/03
More Info
Hello! Thank you for your questions regarding dental care and cavities. It's great that you're taking an active interest in your oral health. Let's address your concerns one by one.
1. Cavities and Dental Treatment: It's concerning that you have multiple cavities, especially if they are severe enough that the dentist has indicated that they may not need immediate treatment. In general, if a cavity is not causing pain, dentists may choose to monitor it rather than intervene right away. However, this does not mean that the cavity will heal on its own. Cavities are caused by the demineralization of the tooth enamel due to acid produced by bacteria in the mouth. Once a cavity has formed, it typically will not heal without intervention. The idea of waiting until it hurts can be risky, as the decay may progress to a point where more extensive treatment, such as a root canal, becomes necessary.
2. Re-mineralization: The concept of re-mineralization is indeed valid. Teeth can undergo a process where minerals, particularly calcium and phosphate, are redeposited into the enamel. This process can be promoted by maintaining good oral hygiene, using fluoride toothpaste, and consuming a diet rich in calcium and phosphorus. Additionally, products containing fluoride or calcium phosphate can help in the re-mineralization process. However, it’s important to note that this process is effective only in the very early stages of decay. Once a cavity has progressed beyond the enamel into the dentin, re-mineralization will not suffice, and restorative treatment will be necessary.
3. Pain and Root Canals: If you are experiencing pain, especially when biting down, it is a sign that the decay may have reached the pulp of the tooth, which contains nerves and blood vessels. In such cases, a root canal may be necessary to remove the infected pulp and save the tooth. Ignoring the pain can lead to further complications, including abscess formation, which can be quite serious. It's crucial to address dental pain promptly to avoid more extensive and costly treatments down the line.
In summary, while monitoring cavities that are not causing pain can be a strategy, it is essential to maintain regular dental check-ups and communicate openly with your dentist about any changes in your symptoms. If you notice any pain or discomfort, it’s advisable to seek treatment sooner rather than later. Additionally, practicing good oral hygiene, including brushing twice a day with fluoride toothpaste, flossing daily, and visiting your dentist regularly for cleanings and check-ups, will help you maintain your oral health and potentially prevent further cavities.
If you have any more questions or concerns, don’t hesitate to reach out to your dentist for personalized advice tailored to your specific situation. Your oral health is important, and proactive care can make a significant difference!
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