Tooth Decay: When to Worry About Nerve Involvement - Dentistry

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Tooth decay, also known as dental caries, is a common dental issue that can lead to serious complications if not addressed promptly. When it comes to understanding the involvement of nerves in tooth decay, it is essential to recognize the stages of decay and the symptoms that may indicate nerve involvement.

In your case, you mentioned that you have a cavity near your upper left wisdom tooth, which has not yet reached the nerve. Your dentist has advised you to observe the situation for two weeks while using protective medications. This is a standard approach when the decay is deep but has not yet caused significant symptoms or nerve involvement.

However, the appearance of a black spot on the side of the tooth and a strange sensation can be concerning. While it is not uncommon for cavities to progress, the presence of a black spot could indicate that the decay is worsening. It is important to note that not all changes in sensation or appearance mean that the decay has reached the nerve. The tooth may still be viable, and there may be options to treat it before nerve involvement occurs.

When decay reaches the nerve, it can lead to pulpitis, which is inflammation of the dental pulp. Symptoms of pulpitis can include:
1. Pain: This can range from mild discomfort to severe, throbbing pain, especially when chewing or when exposed to hot or cold stimuli.

2. Sensitivity: Increased sensitivity to temperature changes or sweet foods can indicate that the nerve is affected.

3. Swelling: In some cases, swelling around the tooth or in the gums may occur.

4. Discoloration: The tooth may become darker as the decay progresses.

If you are experiencing any of these symptoms, it is crucial to return to your dentist for further evaluation. They may perform diagnostic tests, such as X-rays, to determine the extent of the decay and whether it has reached the nerve. If the decay has indeed reached the nerve, treatment options may include:
- Root Canal Therapy: This procedure involves removing the infected pulp tissue, cleaning the root canals, and sealing them to prevent further infection. It can save the tooth and alleviate pain.

- Extraction: If the tooth is too damaged to be saved, extraction may be necessary.

In terms of the protective medications your dentist prescribed, these are typically designed to help remineralize the tooth and protect it from further decay. However, they are not a substitute for definitive treatment if the decay progresses.

In conclusion, while the presence of a black spot and unusual sensations can be concerning, it does not automatically mean that the decay has reached the nerve. It is essential to monitor the situation closely and follow up with your dentist as advised. Early intervention is key to preventing more severe complications, and your dentist will be able to provide the best course of action based on the current condition of your tooth. If you notice any worsening symptoms, do not hesitate to seek immediate dental care.