Root Cavities: Treatment Options and Oral Care Tips - Dentistry

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Root caries


Hello Dr.
Huang, recently I've been experiencing some sensitivity and pain in my teeth when biting down on hard objects.
After visiting a dental clinic for an X-ray, I found out that I have a cavity in the root of my tooth.
The cavity is quite deep.
About half a month ago, during a dental cleaning, I mentioned to the dentist that I sometimes feel sensitivity when drinking cold or hot beverages, and the dentist said it was due to tooth sensitivity.
However, I still felt something was off and was worried, so I went back for a check-up and requested an X-ray, which revealed the cavity in the root, but it hasn't reached the nerve yet.
After the dentist filled the cavity, when I left the treatment room and approached the front desk, the dental assistant said I need to schedule another appointment in half a month.
The dentist mentioned that we would need to assess whether root canal treatment or extraction would be necessary.
Now I feel very anxious and upset; I'm only 23 years old and might have to face tooth extraction, which is making it hard for me to prepare for the upcoming national exam.

I would like to ask the doctor, if I'm told that I need root canal treatment or extraction, should I consult a few more clinics to explore the possibility of saving the original tooth? Or is the situation with root cavities usually that severe? I just turned 23, and I brush my teeth at least twice a day, using dental floss before bed, but I don't use interdental brushes (even the smallest size SSS is difficult to fit between my teeth).
I go for dental cleanings and check-ups every six months.
I feel like I've been taking good care of my teeth, yet I still easily develop cavities, which is quite frustrating.
Recently, I've been considering purchasing a water flosser to assist with my dental care.
Is it suitable to use a water flosser after every brushing (possibly 2 to 4 times a day), or is there a limit to how often it should be used? Additionally, regarding tongue coating, should I brush it until it's almost completely white to help prevent cavities? However, brushing my tongue is quite painful for me… Do you have any recommended methods? Thank you, doctor, for your patience in reading and responding.

Xiao Chen, 20~29 year old female. Ask Date: 2020/05/13

Dr. Huang Tingfang reply Dentistry


Dear Miss Xiao Chen,
Hello! (Root caries) Typically, this occurs in older individuals due to gum recession and inadequate oral hygiene.
Therefore, maintaining proper dental hygiene is crucial! It is recommended to brush your teeth at least twice a day, ideally after meals within 30 minutes.
Proper use of a toothbrush and dental floss is essential; dental floss picks are not recommended.
Additionally, try to limit snacking, especially sugary foods, as they produce acids that can damage tooth enamel and lead to cavities.
Be cautious with strong acids like cola, as they can also contribute to tooth decay.
There is no need to brush your tongue unless there is severe inflammation.
Take care! Wishing you peace and success!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2020/05/13

More Info


Hello! It's understandable to feel anxious about your dental health, especially at a young age when you might not expect to face issues like root cavities. Let's break down your concerns regarding root cavities, treatment options, and how to maintain oral health effectively.


Understanding Root Cavities
Root cavities occur when decay affects the root surfaces of the teeth, often due to gum recession or exposure of the tooth roots. This can lead to sensitivity, especially when consuming hot or cold foods and beverages, as you have experienced. It’s good that you sought a second opinion and had an X-ray taken, as this can help in diagnosing the extent of the decay.


Treatment Options
1. Fillings: If the cavity has not reached the nerve, your dentist may be able to fill it. This is the least invasive option and can restore the tooth's function and aesthetics.

2. Root Canal Treatment: If the decay progresses and reaches the nerve, a root canal may be necessary. This involves removing the infected pulp, cleaning the root canals, and sealing them. While this procedure sounds daunting, it can save your tooth and alleviate pain.

3. Extraction: If the tooth is severely damaged and cannot be saved, extraction may be the only option. However, this is usually a last resort after considering all other treatments.


Seeking Multiple Opinions
It’s perfectly reasonable to seek a second or even third opinion, especially if you are concerned about the recommendations. Different dentists may have varying approaches to treatment, and it’s essential to find one that you trust and feel comfortable with. They can provide insights into whether your tooth can be saved or if extraction is necessary.


Maintaining Oral Health
Your current oral hygiene routine seems solid, with regular brushing, flossing, and dental check-ups. However, here are some additional tips:
- Water Flossers: Using a water flosser can be beneficial, especially if you find traditional flossing challenging. You can use it after brushing, and there’s generally no strict limit on how often you can use it. Just ensure you’re using it correctly to maximize its benefits.

- Tongue Cleaning: While it’s important to keep your tongue clean to reduce bacteria that can contribute to cavities, you don’t need to scrub it raw. Consider using a softer tongue scraper or brush, and be gentle. You can aim for a light cleaning rather than trying to remove all the coating at once.

- Dietary Considerations: Be mindful of your diet. Reducing sugary snacks and drinks can significantly lower your risk of cavities. Incorporating more calcium-rich foods can also help strengthen your teeth.

- Regular Dental Visits: Continue with your biannual dental check-ups. These visits are crucial for catching issues early before they become more serious.


Conclusion
Feeling overwhelmed by dental issues is common, but remember that many treatment options are available to preserve your natural teeth. It’s essential to communicate openly with your dentist about your concerns and treatment options. If you feel uncertain, don’t hesitate to seek additional opinions.
Maintaining a proactive approach to your oral health, including considering tools like a water flosser and being gentle with tongue cleaning, can help you manage sensitivity and prevent further decay. Remember, you’re not alone in this, and with the right care, you can maintain a healthy smile. If you have further questions or need clarification, feel free to ask!

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