How to Clean Deep Tooth Decay

How to clean deep tooth decays?

With the researches and developing technologies in dentistry, each problem has started to have its own treatment methods. Before technological developments, the effects of filling materials and caries cleaning tools on the structure of the tooth were not known. Today, the effects of all these are known and more tissue-friendly materials are produced and new techniques are developed every day. As a result, caries of all sizes are now cleaned with separate special techniques.

Why does caries occur?

When the foods we eat are not cleaned well, they remain around the teeth and microorganisms living by consuming food residues settle in these areas.  The substances produced by these microorganisms cause melting in our tooth tissue. The structure we call caries is the tooth tissue melted with the effect of these substances.

What is the structure of teeth?

The classification of caries according to the amount of progression affects the treatment to be performed. To better understand this classification, let’s first talk a little bit about dental tissues. Our teeth have a layered structure and have 3 layers.

• Enamel
• Dentin
• Pulp

The top layer is enamel. It surrounds the part of the tooth outside the bone and is the hardest and most durable tissue of the tooth. Because of this structure, we can call enamel the armour of our tooth. It protects the tooth and ensures its strength. Underneath this, there is a softer dentin tissue that supports the enamel. This elastic structure of dentin meets the forces coming to the tooth and prevents it from breaking against these forces. Dentin has tiny canals in its structure and has a dynamic structure. There is a cavity inside the tooth and pulp tissue fills this cavity inside the tooth, just as hard bones are filled with bone marrow. The pulp is the living tissue of the tooth, consisting of vessels and nerves.

How does tooth decay progress? What is the treatment of tooth decay?

Dental caries can be divided into 3 groups.

• Enamel caries
• Dentin caries
• Deep dentin caries
• Enamel decay:

Caries starts in the enamel, which is the armour of our teeth, and slowly progresses in the solid structure of the enamel. In fact, if food residues are cleaned well, tooth decay does not pass, but it can remain here for years without progressing as stopped caries. For us, it is the type of caries that we call caries (enamel caries) at the initial level. As a treatment for enamel caries; filling can be done, it can be left untouched and the patient can be told how to clean it to stop the caries or the carious surface can be turned into a cleanable surface.

Dentin caries:

When the caries goes down to the dentin, unfortunately we are not as lucky as with enamel caries. Because now the armour has been pierced and the sensitive dentin tissue with its canals has been reached. Now little by little sensitivities begin. Caries, which progresses very slowly in the enamel, starts to gain speed when it descends to the dentin. At this stage, there is no possibility of stopping the caries. It definitely requires filling. Caries that reach up to half the thickness of the dentin tissue (support tissue under the enamel) are small caries for us and we can easily treat them with filling.

Deep dentine caries:

When half the thickness of the dentin is exceeded by the caries, we consider it to have entered a dangerous area for us. Because these deep caries now begin 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 why there is pain, ache and sensitivity in deep caries. The treatment of deep dentin caries is quafage treatment. If the caries is not treated at this stage, microorganisms progress and reach the pulp. Severe pain starts and requires root canal treatment.

How to clean deep tooth decay?

A special protocol is applied when cleaning deep caries that has reached the dangerous area. No caries that has reached the dentine will not pass, heal, and the caries cannot be cleaned at home. Because the tooth is a sensitive tissue and requires sensitive intervention with special cleaning tips for each layer. Firstly, the enamel is removed with diamond tips so that all caries tissue is visible. Then, the decay is cleaned with the environmental cleaning method, starting from the surrounding walls of the dentin tissue, towards the nerve tissue (pulp) inside the tooth. At this stage, cleaning is done very gently, without pressure and under appropriate cooling using dentin-specific steel or tungsten carbide tips. In addition to these, we perform our disinfection protocol, which we apply in every filling, more frequently. Because a surface free of microorganisms as much as possible, even if we get very close to the pulp, gives us the chance to save the tooth with appropriate materials.

Is there pain after quafage treatment?

After the treatment of deep caries (quafage), teeth may be more sensitive than other teeth, even if they remain alive. They especially feel the cold more, but this is usually only temporary. If you experience severe, throbbing pain that wakes you from sleep after treatment of a tooth with deep decay, we recommend that you see your treating dentist. It may be that your tooth has not tolerated the treatment and requires root canal treatment.

How to prevent caries progression?

Sometimes, even though our patients are aware of their problems, they may neglect their treatment for some reasons. Since there are no methods to remove, clean or pass tooth decay at home, it is absolutely necessary to consult a dentist. Otherwise, initial or shallow caries will grow when left untreated.  This means more tissue loss and risk. In addition, caries does not only start from the upper part of the teeth, but mostly from the interfaces where the teeth touch each other. The fact that interfacial caries do not cause high sensitivity, are not obvious except for detailed examination in the mouth, and some of them cannot be detected without dental X-rays causes many people not to notice their caries. For these reasons, we recommend that you have a general dental examination every six months, have your dental films taken in line with the guidance of your dentist, and wish you a healthy day.

Çürük ilerlemesi nasıl önlenir?

Bazen hastalarımız problemlerinin farkında oldukları halde bazı sebeplerden tedavilerini ihmal edebilmektedirler. Diş çürüğünü evde giderme, temizleme ya da geçirme yöntemleri olmadığı için mutlaka bir diş hekimine danışılması gerekmektedir. Aksi taktirde başlangıç seviyesinde ya da derin olmayan çürükler tedavi edilmediğinde büyürler.  Bu, daha fazla doku kaybı ve risk demektir. Bunun yanı sıra çürükler sadece dişlerin üst kısmından başlamaz, hatta çoğunlukla dişlerin birbirine değdiği ara yüzeylerden başlar. Arayüz çürüklerinin yüksek hassasiyet yapmaması, ağız içinde ayrıntılı muayene dışında belli olmaması, hatta bazılarının diş filmi çekilmeden tespit edilememesi bir çok insanın çürüklerini fark edememesine sebep olur. Bu sebeplerden ötürü biz, altı ayda bir genel diş hekimi muayenenizi yaptırmanızı, diş hekiminizin yönlendirmesi doğrultusunda diş filmlerinizi çektirmenizi öneriyor, sağlıklı günler diliyoruz.