Dental caries


How to treat tooth decay without a cavity?
Once a cavity forms, there is definitely a cavity hole. It might appear that there is no hole on the surface, but the texture has already softened, forming a cavity hole; it's just that it has not been discovered by oneself. It can be seen by a doctor using an examination and can also be detected by taking dental X-rays. At this point, one should follow the treatment principles for cavities, which involve removing the decayed and necrotic material inside the cavity and then filling it with filling material. If it is an interproximal cavity, the decay inside can be removed via an X-ray and then filled. Some occlusal pit and fissure caries, which are relatively shallow, can be treated with topical fluoride medication. For cavities, it is important to detect and treat them early. Regular oral hygiene should be maintained, with brushing in the morning and evening, and rinsing after meals. If a cavity is not treated in time, it will become deeper and ultimately turn into a residual root, which will need to be extracted.


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.


How to prevent cavities in children
Prevention of tooth decay in children should first encourage them to develop good tooth-brushing habits, reducing bacteria and plaque on the tooth surface, and include brushing in the morning and evening, as well as rinsing after meals. Enamel is the hardest substance in the human body but is susceptible to cracking. Acidic or sugary substances are harmful to teeth, so it's best to avoid sweets and acidic foods in the evening and to brush teeth before going to bed. Brushing teeth before sleeping is crucial and some anti-cavity treatments should be done, such as fluoride application or dental sealants. It's also important to develop a habit of regular dental check-ups to detect and treat cavities early.


How to treat children with dental caries?
To treat cavities in children, first, the extent of tooth decay needs to be assessed. If the decay is mild, the decayed part can be removed and directly filled. If the decay is severe enough to inflame the dental nerve, an X-ray of the tooth is required. If it is a deciduous tooth that is about to fall out soon and is not worth saving, treatment might be unnecessary. However, if the tooth root has not been absorbed and the permanent tooth will take a long time to erupt, root canal treatment can be considered. In cases where a young permanent molar is decayed and the nerve is infected, a vital pulpotomy should be performed to preserve the living pulp and promote further development of the tooth root.


What is the reason for black dental caries?
Cavity prevalence is quite high, especially in children who haven't developed good oral hygiene habits and consume a lot of sweets, making them prone to cavities. Early detection is thus very important. Early symptoms of cavities are not obvious, but with careful observation, one can notice parts of the teeth turning black. This is due to bacterial erosion and damage to the teeth. Damage occurs to the enamel and dentin of the teeth. If this continues to develop, it can lead to damage to the dental pulp, resulting in pulpitis. Therefore, when you notice your teeth turning black, it is crucial to seek timely treatment to prevent the progression to pulpitis.


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.)


If half of the cavity is empty, should the tooth be extracted?
Whether a tooth that is half decayed should be extracted depends on the condition of the patient's tooth root. It is recommended that the patient first undergo a dental X-ray to ascertain whether the tooth root is intact. If the tooth root is relatively sound, generally, extraction is not necessary. The decayed material in the tooth can be removed, followed by a pulp capping procedure, and then filling. Due to the severity of the decay, it is advisable to wear a porcelain crown for protection. If the decay has affected the dental pulp causing pulpitis, root canal treatment should be performed before filling the tooth and protecting it with a porcelain crown. However, if the tooth root is severely damaged, considering tooth extraction might be necessary.


If the cavity doesn't hurt, does that mean it hasn't reached the nerve?
It is necessary to make judgments based on the patient's symptoms and examination results. Dental caries refers to the chronic, progressive, destructive disease occurring in the hard tissues of the teeth under the influence of various factors such as plaque bacteria. Whether dental caries is painless or has reached the nerve, the simplest clinical method is to judge based on the patient's symptoms, asking whether the patient experiences pain. In the early stages, there are only changes in the color and texture of the tooth, which do not cause pain. In the later stages of the disease, due to necrosis of the dental pulp, pain may not occur. At this time, diagnosis can be assisted by dental films; an X-ray can show the low-density shadow produced by the caries, and whether this low-density area significantly erodes into the dental pulp, which is also an auxiliary diagnostic method. Therefore, it is important to maintain oral hygiene, brush teeth morning and evening, and rinse mouth after meals.


Can tooth decay pain be relieved with Sichuan pepper?
If a patient has dental caries and is experiencing considerable pain, and there are no medications available nearby, they can temporarily use Sichuan peppercorns for pain relief. This is because certain components within Sichuan peppercorns can alleviate some of the pain, although they do not treat the dental caries directly. Thus, it is recommended that if a patient is suffering from toothache due to dental caries, they should seek timely treatment at a hospital. The specific treatment plan should be based on the extent of damage caused by the dental caries. If the damage is minor, the tooth generally does not require special treatment; however, if the dental caries are severe and have damaged the tooth structure, root, or even the dental nerves or gum tissue, it is advisable for the patient to consider tooth extraction followed by a dental restoration. The specific recommendations should still be based on a doctor’s diagnosis and a tailored treatment plan should be established.


Can tooth decay be cured?
Cavities are a type of destructive dental hard tissue disease caused by bacterial infections and are also a chronic progressive infectious disease. Cavities can only improve through early and effective intervention and treatment; otherwise, the condition may develop further, leading to pulpitis or apical periodontitis. Severe cases can also cause systemic symptoms such as space infections, and some may lead to bacteremia or sepsis. In the early stages of development, cavities have no clinical symptoms. At this stage, filling the cavity is painless. If the decay progresses to reach or approach the dental nerve, filling the cavity can then cause widespread pain. If it reaches the dental nerve, it cannot be directly filled in one go; it requires dental treatment for improvement.