How to deal with toothache from cavities?

Written by Li Bao Hua
Dentistry
Updated on September 04, 2024
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Cavity toothache occurs when bacteria infect the hard tissue of the tooth, approaching or reaching the dental nerve, causing a pain response from the nerve, which is also a self-protective reaction. Initial treatment for cavity toothache involves using a drill to remove the decayed hard tissue of the tooth. If the decay is completely removed and the dental nerve is not exposed, this condition can be directly treated by filling or using a pulp-capping agent to protect the nerve before filling. If, after removing the decay, the dental nerve is exposed or reached, the situation cannot be resolved with a direct and immediate filling. Instead, nerve-killing procedures are necessary, which involve root canal treatment of the tooth.

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Does a cavity mean tooth decay?

The common term for dental caries is tooth decay. In the past, many people believed that tooth decay was caused by a kind of "tooth worm" that eroded the teeth, leading to tooth damage. In fact, it's the presence of a large amount of dental plaque and tartar on the teeth, and the erosion caused by numerous bacteria on these surfaces, which is what we now refer to as the phenomenon of caries, causing the teeth to turn black. Severe erosion can affect the enamel and dentin, and if it breaks through to the dental pulp, severe pulpitis can occur. When suffering from dental caries, it is essential to seek early treatment to remove the necrotic enamel and further prevent its progression.

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What will happen if a cavity is filled without being cleaned properly?

If tooth decay is not completely cleaned out before filling, bacteria can continue to develop and multiply within the tooth, leading to more severe decay and potentially causing diseases such as pulpitis or periapical periodontitis. It is recommended that patients with cavities should undergo treatment based on the severity of the decay. Mild cavities usually only cause minor changes in tooth color; this can be gently abraded and then treated with fluoride materials. If the cavity is more severe, the decayed material inside the cavity should be completely removed, and then light-cured resin material can be used for filling. Deeper cavities may also require a protective pulp base.

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What to do if you have tooth decay and swollen, painful gums?

When patients experience dental caries and swollen, painful gums, it is advised that they seek medical attention promptly. They may take some anti-inflammatory and analgesic medications to relieve inflammation and pain. After the inflammation has completely subsided, treatment should be based on the extent of damage to the dental caries. If the damage to the dental caries is minor, conservative treatment may be sufficient. However, if the damage is severe, it may affect part of the tooth structure or even the entire tooth and root, possibly leading to cavitation. In such cases, it is recommended that patients consider tooth extraction or filling as remedial measures. Additionally, patients must pay attention to oral hygiene and develop correct tooth brushing habits. (The use of medications should be under the guidance of a professional doctor.)

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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.

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Will tooth decay affect the replacement of teeth?

Cavities can have a certain impact on tooth replacement. Cavities are a chronic progressive destructive disease caused by bacterial infection of the hard tissue of the tooth. If not treated in time, it may further develop, forming pulpitis or even apical periodontitis. Once it reaches the stage of apical periodontitis, it may form a gum abscess, or even swelling. During the process of new teeth eruption, they emerge outward through the position of the old tooth roots by absorbing the roots of the old teeth. If there is severe inflammation in the eruption pathway, it may lead to the destruction of the dental follicle of the new tooth, causing a developmental defect in the enamel of the new tooth. Therefore, it is possible that cavities can affect tooth replacement.