Ideally every body wants to have carious free mouth with no decay and where dental filling is not required. But this is not the case always. Because of unhealthy eating habits and practice of poor oral hygiene, the teeth get caries. When the teeth get carious, to save them they have to be filled and for that filling material is required. Every material can not be used as the filling material. The material which full fills the criteria for the ideal filling material can only be used as the filling material. Now before going into the details of filling material we should know what dental caries are and how they are formed.
Dental caries is also known as the Tooth Decay. It can be defined as the infectious microbial disease causing the localized dissolution and destruction of the calcified tissue of the tooth structure.
Causes of the Dental Caries
Dental caries is the multifactorial disease. For a particular tooth to get carious there should be carious prone tooth structure like the tooth having deep pits and fissures, microbes like streptococcus mutans, food particles and the time. If all these factors are present then the tooth gets carious. The microbes will ferment the food particles and produce acid. This acid will cause the dissolution and the destruction of the tooth surface causing caries. These microbes along with the food particles and other cells also form the plaque which adheres to the tooth surface causing other dental problems like gum diseases. It is also the causative factor for caries.
Signs and Symptoms of Dental Caries
The signs and symptoms of the carious tooth depend upon the extent of the caries and the intensity. If the caries is not very deep then initially the patient may not feel any thing but if it reaches dentine then the patient can have hot and cold sensation and if it further involves the pulp then the person can have severe pain and the swelling.
Some times carious process is very slow. It is not acute but chronic. Patient may not feel much discomfort and the decay affects the pulp making the tooth nonvital.
The discoloration of the tooth is another sign of the carious tooth.
Patient complains of food lodgment in that area which has a cavity. Some times the cavity is not visible. It is hidden, only x- ray can help to diagnose the cavity.
if the cavity is in the anterior tooth then it gives very unaesthetic appearance.
There is difficulty in chewing from that side.
All these signs and symptoms points towards the presence of caries but detailed clinical examination, history and the x-ray’s are required for making the diagnosis.
When the filling is required
Now the question arises when exactly the filing is required? In the initial stage when the caries involve the outer surface of the tooth that is the enamel the patient does not feel any signs or symptoms. There is no pain and no sensitivity to hot and cold sensation, as the enamel is nonvital and it does not have any nerve endings. The only problem that the patient feels is the food impaction and most of the time one over looks it but if one gets the cavity filled at this stage, it will last for longer duration and the tooth loss is less. If one does not get it filled at this stage then the caries involves the next layer that is dentine. Dentine is the vital part of the tooth and the patient feels the hot and cold sensation. At this stage pain to hot and cold sensation is there till the stimulus is there. As soon as the stimulus is removed the pain vanishes. The filling can be done at this stage also. But if the cries progresses further and the pulp tissue is involved which is the inner most layer and is the soft tissue containing the blood and nerve supply of the tooth, then the tooth can not be restored by the simple filling. At this stage the root canal has to be done and after the root canal treatment it is advisable to give the crown on the tooth.
Dental Amalgam Restoration Dental Composite Restoration
Root Canal Treatment When Infection Reaches Dental Pulp
So we say that at the very initial stage the tooth has a chalky white appearance. It means that the demineralization of the tooth has started but if the proper precautions are taken then this process can be reversed at this stage. But if the cavity develops, that is when there is a catch point with the explorer then it is indicated to get the filling done.