How to perform pulp drainage for dental caries?

Written by Li Bao Hua
Dentistry
Updated on September 12, 2024
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Pulpotomy and drainage for caries involve a treatment method for acute pulpitis or apical periodontitis caused by infected dental nerves. Teeth are composed of enamel, dentin, cementum, and pulp tissue. The pulp tissue, also known as the dental nerve, is located within the innermost part of the tooth, surrounded by the hard layers of dentin and cementum. Therefore, once the dental nerve becomes inflamed, the pressure within the pulp chamber rapidly increases. To alleviate the pain, it is necessary to release this pressure, namely by performing a pulpotomy and drainage. This can be done by drilling to remove some of the infected dental tissues, and then opening up the pulp chamber to relieve the pressure, significantly reducing the pain. If the dental nerve is completely purulent and necrotic, the top of the pulp chamber can be removed, followed by thorough pulpotomy and drainage.

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Permanent tooth decay

Permanent tooth decay refers to the decay occurring in newly erupted teeth. The most common case is the first permanent molar, also known as the six-year molar, which emerges quietly in the mouth at the age of six. Once this tooth emerges, it cannot be replaced for life. If this tooth decays, it is necessary to fill the tooth as soon as possible; otherwise, if the decay reaches the dental nerve, it could lead to pulpitis. Alternatively, for newly erupted teeth, sealants should be applied to the pits and fissures of the teeth to slow down the pace of decay. Permanent tooth decay requires us to intervene with treatment as early as possible; otherwise, it may cause pain or even tooth loss.

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How to prevent dental caries

Cavities are a destructive disease caused by bacterial infection of the hard tissues of the teeth. The first step in preventing cavities is to understand the causes and implement basic prevention measures. Firstly, the condition is associated with bacterial infection, and controlling dental plaque through effective brushing can help. Data shows that dental plaque can easily reattach to teeth within eight hours after brushing. Therefore, it is recommended to brush your teeth twice a day, in the morning and evening. Some people are accustomed to brushing at night and just rinsing in the morning; however, this practice is incorrect as effective brushing helps control the accumulation of dental plaque. Secondly, diet plays a role, with sugary foods, especially sucrose, being particularly conducive to cavities. It is advisable to reduce the intake and frequency of sugar consumption. Additionally, effectively supplementing calcium can help prevent inherent enamel hypoplasia of the teeth. If the mother experiences calcium deficiency during pregnancy, there is also a higher risk of cavities.

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Dentistry
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What will happen if tooth decay is not treated?

If dental caries are not treated, they may further infect and cause inflammation of the dental nerves, leading to pulpitis or apical periodontitis, causing severe pain. When apical periodontitis occurs, it may sometimes lead to a space infection, which is facial swelling. If the inflammation is not controlled in time, it may also cause osteomyelitis of the jawbone. Therefore, dental caries need to be treated as early as possible. Dental caries are caused by bacterial infections that lead to the decay of the hard tissues of the teeth; in the early stages of decay, using a drill to stop the development of the disease—namely, timely filling—can effectively control the further progression of dental caries. If dental caries further infect and cause inflammation of the dental nerves, it can lead to pain while eating or sleeping, sometimes waking from sleep due to pain, and in severe cases, it can cause facial swelling.

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Dentistry
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Can cavities be seen with the naked eye?

Some cavities are visible to the naked eye, while others are not. Clinically, some cavities can be observed with the naked eye. Such cavities usually have damage that extends beyond the enamel, with obvious cavities and incomplete tooth structures visible. For example, cavities on the biting surfaces of molar teeth and on the adjacent surfaces of front teeth that are moderate to severe can be seen with the naked eye. However, not all cavities can be observed with the naked eye. When the decay is confined within the enamel without obvious cavity formation, it cannot be seen with the naked eye, but it can be diagnosed by taking dental X-rays. Clinically, there are also some cavities on adjacent surfaces where the decay starts from hidden parts of the tooth; some of these might show ink-soaked-like dark brown discoloration on the biting surfaces, but they too require dental X-rays for diagnosis.

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Will tooth decay recur after a filling?

Cavities are a type of chronic, progressive destructive disease caused by bacterial infection of the hard tissues of the teeth. Normally, a cavity should not recur after being filled, but each dental filling material has a certain degree of microleakage. If glass ionomer materials are used, the microleakage is somewhat larger, and after filling, there might be tiny gaps between the edge of the filling material and the tooth, where bacteria can continue to infect, also known as secondary caries, necessitating timely refilling of the tooth. If resin-based materials are used, the microleakage is relatively smaller, and the likelihood of recurrence after the filling is smaller.