What should I do about permanent tooth decay?

Written by Li Bao Hua
Dentistry
Updated on September 25, 2024
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Permanent tooth decay refers to the decay that occurs in children's newly emerged permanent teeth or already replaced permanent teeth. Once decay occurs in a permanent tooth, it is necessary to fill the tooth as soon as possible. Decay is removed by drilling out the decayed hard tissue of the tooth. After removal, direct pulp capping treatment for the tooth is performed. If the decay in the permanent tooth is deep and has reached the tooth nerve, pulp treatment is needed. Vital pulpotomy can be used to retain the root pulp of the root part to promote further development of the tooth root. If the apex of the root has already formed in the permanent tooth and decay occurs, and the tooth nerve cannot be preserved, we can directly proceed with root canal treatment.

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Can cavities be transmitted to other people?

Cavities are not contagious to other people. Cavities themselves are not considered a contagious disease. The development of this condition is a long-term and complex process, not merely caused by the transmission of pathogens. Initially, there are some pits and fissures on a patient's teeth which are easily attacked by acidic substances produced by bacteria, leading to the demineralization of calcium in the enamel, thereby softening and collapsing the enamel. If a patient frequently consumes sweet foods and neglects oral hygiene, not brushing or rinsing thoroughly, it could lead to bacteria decomposing these sweet food residues, continually damaging the patient’s teeth and resulting in cavities.

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The causes of dental caries formation

The causes of dental caries include bacterial factors, dietary factors, the tooth's own factors, and time factors, also known as the four-factor theory of dental caries. Dental caries initially result from bacterial infection. Under such infections, the hard tissues of the tooth undergo a chronic destructive deterioration; over time, this results in cavity formation. That is to say, the formation of dental caries primarily occurs under bacterial infection. Additionally, diet is a main cause of dental caries, especially sugary foods. Bacteria use glucose to produce acid, leading to tooth demineralization and cavity formation. Moreover, congenital calcium deficiency in teeth, leading to incomplete enamel development, is also an important cause of dental caries. Furthermore, the formation of dental caries requires a certain time factor.

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If a cavity is not thoroughly cleaned before being filled, what will happen?

When a patient has severe dental caries and undergoes filling, if the decay is not completely removed before filling, it may lead to reinfection and residual decay, continuing to cause inflammation. Therefore, it is recommended that the decay be completely removed before filling. In such cases, it is generally safe for patients to seek treatment at a formal dental hospital. Official hospitals adhere to strict standards, effectively cleaning the affected area for filling and repair. Therefore, patients need not be overly anxious; this type of procedure is quite common in dentistry. Patients are advised to maintain good oral hygiene in daily life and seek timely medical attention when dental caries occur.

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Why do cavities turn black?

Cavities generally appear black, while normal teeth are white. The structural changes in the dental tissues due to bacterial infection cause the hard tissues of the teeth to demineralize, enlarging the internal spaces of the teeth. This can cause cavities to appear black under the refraction of sunlight, resulting in a black appearance. Additionally, after the deterioration of the tooth due to decay, the breakdown of the hard tissue allows food residues or plaque to enter the cavities, which can also cause the cavities to turn black. This situation requires early dental filling to remove the decayed parts, followed by root canal treatment, otherwise it can lead to pulpitis, causing tooth pain.

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Can a cavity that exposes the dental pulp be filled?

Cavities that expose the dental pulp cannot be directly filled in one session. Treatment of the tooth must be carried out before filling. In the early stages of a cavity, only the hard tissue of the tooth is damaged. If the decayed part is removed promptly and the dental nerve is not exposed, the tooth can be directly filled in one session. However, if the cavity progresses to the point where the dental pulp, or nerve, is exposed, this requires a nerve removal procedure. After the nerve is killed, the root canal is sealed with medication, and following inflammation control, the root canal is filled. Only after root canal treatment can the tooth be filled. Otherwise, the inflammation may further develop into apical inflammation, or even lead to space infections causing facial swelling.