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How to clean deep tooth decay?
Why does caries occur?
When the food we eat is not cleaned well, it remains around the teeth and microorganisms that live by consuming food residues settle in these areas. The substances produced by these microorganisms cause dissolution in our dental tissue. The structure we call decay is the dental tissue that has dissolved under the influence of these substances.
What is the structure of the teeth?
Classification of caries according to their progression affects the treatment to be performed. To better understand this classification, let's first talk a little about dental tissues. Our teeth have a layered structure and have 3 layers.
- Enamel
- Dentine
- Pulp
The top layer is enamel. It surrounds the part of the tooth that is outside the bone and is the hardest, most durable tissue of the tooth. Because of this structure, we can call enamel the armor of our teeth. It protects the tooth and provides its strength. Underneath this, there is support for the enamel and a softer dentin tissue. This elastic structure of the dentin counteracts the forces coming to the tooth and prevents it from breaking under these forces. There are tiny channels in the structure of the dentin and it has a dynamic structure. There is a space inside the tooth and just like the inside of the hard bones is filled with bone marrow, this space inside the tooth is filled with pulp tissue. Pulp is the living tissue of the tooth, consisting of blood vessels and nerves.
How does tooth decay progress? What are the treatments for tooth decay?
We can divide tooth decay into 3 groups.
- Enamel caries
- Dentin caries
- Deep dentin caries
Enamel caries:
Decay starts first in the enamel, which is the armor of our teeth, and progresses slowly in the solid structure of the enamel. Even if food residues are cleaned well, tooth decay does not go away, but it can remain there as decay without progressing for years. What we call initial decay (enamel decay) is the type of decay. As an enamel decay treatment; a filling can be applied, the patient can be told how to clean it to stop the decay without touching it, or the decayed surface can be turned into a cleaned surface.
Dentin caries:
When the decay reaches the dentin, unfortunately we are not as lucky as the decay in the enamel. Because now the armor has been pierced and the sensitive dentin tissue with its small channels has been reached. Now small sensitivities begin. The decay that progresses very slowly in the enamel starts to gain speed when it reaches the dentin. At this stage, there is no chance for the decay to stop. It definitely requires a filling. Decay that reaches half the thickness of the dentin tissue (supporting tissue under the enamel) are small decays for us and we can easily treat them with fillings.
Deep dentin caries:
When the half thickness of the dentin is exceeded by the caries, we consider it to have entered the dangerous area for us. Because these deep caries now start to affect the pulp inside the tooth, that is, the vascular and nerve tissue of the tooth, and the tooth makes some changes in its structure to protect itself. This is the reason for the pain, ache and sensitivity in deep caries. The treatment of deep dentin caries is capping treatment. If the caries is not treated at this stage, microorganisms progress and reach the pulp. Severe pain begins and requires root canal treatment.
How to clean deep tooth decay?
A special protocol is applied when cleaning deep caries that have reached the dangerous area. No caries that have reached the dentin will pass, heal, and caries cannot be cleaned at home. Because the tooth is a sensitive tissue and requires delicate intervention with special cleaning tips for each layer. First, the enamel is removed with diamond tips so that all the caries are visible. Then, the caries and dentin tissue are cleaned with the environmental cleaning method starting from the surrounding walls and towards the nerve tissue (pulp) inside the tooth. At this stage, the cleaning is done very gently, without pressure and under appropriate cooling using special steel or tungsten carbit tips for dentin. In addition, we perform our disinfection protocol, which we apply to every filling, more frequently. Because a surface as free of microorganisms as possible gives us the chance to save the tooth with appropriate materials, even if we get very close to the pulp.
Is there any pain after the capping treatment?
After the treatment of deep caries (capping), teeth may be more sensitive than other teeth even if they remain alive. They are particularly sensitive to cold, but this is usually temporary. If you have severe, throbbing pain that wakes you up from your sleep after the treatment of a tooth with deep caries, we recommend that you see your treating physician. If your tooth could not tolerate the treatment and may need root canal treatment.
How to prevent caries progression?
Sometimes, our patients may neglect their treatment for some reasons even though they are aware of their problems. Since there are no methods to remove, clean or cure tooth decay at home, it is essential to consult a dentist. Otherwise, early-stage or shallow decay will grow if left untreated. This means more tissue loss and risk. In addition, decay does not only start on the upper part of the teeth, but mostly on the interdental surfaces where the teeth touch each other. The fact that interdental decay does not cause high sensitivity, is not noticeable outside of a detailed examination in the mouth, and some cannot even be detected without taking dental films causes many people to not notice their decay. For these reasons, we recommend that you have a general dentist check-up every six months and have dental films taken as directed by your dentist, and we wish you healthy days.
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