A Summary of Tooth Decay
Pit and Fissure Decay:
This dental infection is limited to the enamel layer of the teeth. It is commonly seen in teeth with deep grooves or in defects of the enamel. This is active decay that must be treated. This decay is easy to overlook or dismiss. Careful examination is required. When evident, treatment is simple, cosmetically acceptable and no anesthesia is required. Micro abrasion with silica particles or macro abrasion with diamond instruments is fast, simple, and painless. Tooth matching composite dental materials are used to bond and repair the area. Dental Sealants are used in the grooves of new newly erupted teeth in children to prevent this decay.
This dental infection covers all other decay that has penetrated through the enamel of the tooth. The dentinal and/or the pulpallayers will be involved. The dentin layer is immediately below the enamel layer. Unlike enamel the dentin has microscopic nerve supply throughout. It comes from the pulp, the hollow nerve and blood vessel chamber deep inside each tooth. This decay is usually symptomatic, ranging from slightly sensitive to roaring toothache. More severe symptoms like spontaneous pain, which is pain for no apparent reason, or sensitivity to pressure often indicate that the infection has spread to the pulp chamber. Decay that extends near the pulp chamber is seen by x-ray. However, since the dentinal layer is infused by microscopic projections of the pulp, many times even shallow, early-detected decay can already be infecting the pulp chamber. This is the reason decay needs to be avoided. Even the smallest decay of the dentin can result in pulpal injury.
Pulpal injury is the inflammation or outright infection of the nerve and blood vessel inside the tooth. It probably is or has caused a toothache. Simply repairing the decay, fixing old dental work, or stopping the apparent cause is not enough. Treatment involves removing the infected pulp tissue from the pulp chamber and the canal system inside each root and sealing the empty space. The other treatment option is extraction of the tooth. Common causes of pulpal injury are decay, trauma, malpositioned teeth, grinding, wearing, failing old dental work, and just advanced age.