By the term "internal caries", an ordinary patient in a dental clinic usually understands a disease that affects tissues deep under the tooth enamel. At the same time, doctors know that, by and large, any tooth decay affects the internal tissues of the tooth, which are softer and more easily damaged than enamel. Therefore, the phrase "internal caries" can be applied to almost any case of the disease and, by and large, is a tautology.
In some cases, they talk about internal caries when they mean a pathological process under a crown or poorly installed filling. Here, caries inside the tooth develops absolutely imperceptibly for both the doctor and the patient, and gives itself out only when the pathological process enamels around the fillings (crowns) or when pain occurs. But again, this is the same ordinary caries, just with non-standard localization.
However, the reasons diagnosis and treatment of caries inside the tooth have their own specifics.
Signs and appearance of teeth with deep caries
In the photo below - internal caries on the tissues under the destroyed enamel. This is a typical type of disease that develops inside the tooth. Dark areas of affected dentin are clearly visible:
It is the changed color of the tissues damaged by caries that is the main diagnostic sign of the disease. In the vast majority of cases, it is precisely on the black dots on the enamel or on the fissures that the doctor unambiguously makes the diagnosis of caries.
From the practice of the dentist
Black dots on the teeth can indicate either congenital or acquired (most often) pigmentation (“smoker's plaque”, etc.), but more often - hidden caries. When you start to drill such points, they go so deep that 70-80% of the points within the enamel are completely removed, and 20-30% reach the dentin, and sensitivity appears (if the patient, due to refusal of anesthesia, asked to manipulate the conditions, until it becomes painful). Since the patient is always right, we act according to the situation: it becomes painful - we coordinate and conduct an anesthesia for the brave client according to the protocol.
Sometimes even severely damaged teeth with internal caries may seem completely healthy. So, if the surface with which the damage began is firmly attached to the other tooth, caries can develop deep in the internal tissues, and even with a close examination of the oral cavity with the naked eye it goes unnoticed. A similar situation is when caries inside a tooth develops from damage in the enamel located below the soft tissues of the gums (root caries).
In most cases, at the first examination of the teeth, their walls (surfaces) affected by caries are striking. These are often not cavities at all, but simply gray, tarnished enamel, which has lost its healthy appearance due to demineralization.
Often, the dentist sees a “tunnel” between the teeth, but the probe may not pass into the hidden internal carious cavity due to the density of the interdental space. Usually, the doctor shows the patient grayish shades of enamel in the mirror against the background of developed internal caries and begins tooth treatment after anesthesia.
When boron touches the gray enamel, in almost 90% of cases it breaks off after a couple of seconds and the boron falls into the internal cavity with an abundance of carious, pigmented, infected and softened dentin. If the doctor performed the anesthesia correctly, there is absolutely no pain.
The doctor conducts cleaning and filling the tooth strictly according to the protocol for the treatment of caries.If there is already a message in the tooth with the pulp chamber (the cavity where the nerve is located), then the doctor performs depulpation and filling of the canals with the subsequent placement of a permanent filling in one or two visits.
The photo below shows a tooth in which deep internal carious cavities are visible under bright light:
The following photo shows fissure caries, that is, localized in the area of the natural relief of the teeth. Under such darkening, significantly destroyed tissues are often hidden inside, which are not immediately detected during a routine examination:
At home, such an "internal caries" is almost impossible to detect. It gives itself out only with extensive damage to the dentin and the appearance of pain in the tooth when the pulp is included in the pathological process. That is why prophylactic visits to the dentist are so important that special methods can detect caries at any of its localization and cure the tooth before it is necessary to remove it (nerve removal).
Reasons for the development of deep caries
The causes of caries in deeply located tooth tissues are similar to those for caries with any other types of localization. The disease develops due to the following factors:
- The constant presence in the oral cavity of acids, both those that came here with food (fruits, vegetables), and those produced by bacteria that consume the remains of almost any carbohydrate food - flour, sweets, cereals.
- Decreased secretion of saliva or its low bactericidal activity. This can be caused by other diseases or metabolic disorders.
- Mechanical and temperature damage to tooth enamel.
- Hereditary factors.
Caries usually develops under the influence of a complex of several such factors.
In any case, it is in the deep, under the enamel parts of the tooth, caries develops most quickly due to the greater susceptibility of tissues to the action of acids. Therefore, situations are not uncommon when under a barely noticeable (and even generally invisible to the naked eye) hole is an extensive cavity destroyed by a carious process.
On a note:
That is why the enamel almost always breaks off (disappears in a piece) when a large carious cavity has already formed, which affects the layers of softened infected dentin. That is, enamel can hold the load for a long time, hanging over a hidden carious cavity, often without giving it away.
Features of the diagnosis of caries inside the tooth
Tooth decay inside a tooth is much more difficult to diagnose than normal, which has manifestations on the enamel surface. It can be clearly seen when using the following diagnostic methods:
- A visual examination in which the doctor may notice cavities darkening under the enamel.
- The use of caries markers - special brightly colored fluids that linger on caries damaged surfaces. With internal caries, they determine the boundaries of damaged tissues after opening the enamel. In dental practice, 2% methylene blue or fuchsin-based preparations are usually used.
- X-ray, in which deep cavities affected by caries have a much darker color.
- Transillumination (shining a tooth with bright light) and luminescent diagnostics (the same, but with the use of ultraviolet light). With this translucency, internal lesions of the tooth become clearly visible.
- Laser diagnostics is a method whereby a laser beam is directed to a tooth, which initiates the tooth’s own glow. Caries-affected tissues emit light in a range different from that in healthy areas. This is fixed by the device, which gives a sound signal and displays the results in graphical form on the computer screen.
In addition, advanced internal caries causes pain in the patient, initially mild and arising mainly when chewing hard foods and getting very cold foods on the tooth, and intensifying as the disease progresses. If the tooth begins to ache regularly without visible damage, you must certainly come to the dentist for an examination.
The following methods can be used as auxiliary for the diagnosis and confirmation of caries inside the tooth:
- Fissurotomy is the minimum opening of enamel over a (presumably) carious cavity with the help of special thin burs. It is usually carried out not to confirm the diagnosis, but to clarify the boundaries of the carious site.
- EOM - electrodontometry. With it, the tooth is exposed to weak currents to determine the threshold of its sensitivity. This allows you to distinguish internal caries from pulpitis.
Rules for treating a disease
In all cases of development of caries inside the tooth, its treatment requires opening the enamel, removing the affected dentin and filling the cleaned cavities. In a neglected form, internal caries leads to the need to remove the nerve and fill the canals.
Even more difficult are situations when a significant amount of tissue is damaged by caries from the inside of the tooth, and it breaks, either after their removal or simply because of softening. In this situation, often, according to indications, it is necessary to remove the tooth with the subsequent installation of the implant at the request of the patient, or do with modern prosthetics methods.
On a note
Split split - discord, therefore, tooth-preserving techniques may include, for example, tooth restoration on a titanium (anchor, fiberglass) pin after thorough intracanal treatment + installation of a crown (cermet, stamped, cast, etc.), may involve tooth preparation under the tab, set tabs + crowns. There may be many options.
Sometimes the lesions are quite extensive, but with them it is possible to maintain the roots of the tooth by removing the pulp from them. In such cases, it is possible to dispense with the installation of a crown.
In any case, after detecting the cavity, the doctor carries out its cleaning with the help of boron. If such tissues fit close to the pulp, their removal can be painful and most often done using local anesthesia.
From dental practice
There are ambiguous situations when the area of the pulp during cleaning of the carious cavity has not yet been opened, but the patient already begins to experience pain during the work of the doctor. It’s definitely not possible to say whether depulpation is necessary here or not. Without depulpation after placement of the filling, it can begin to disturb the nerve endings during chewing and cause pain. Some doctors are inclined to depulpate such a tooth so that they do not have to carry out repeated work if, after installing the seal, the patient begins to experience pain. Other dentists explain the situation in detail to the patient and make a decision together with him. It should be borne in mind that many patients are very sensitive to the preservation of their teeth in a “live” form and are ready to take risks so that they can go around with a tooth with preserved pulp for several more years if pain does not occur after simple filling.
In general, even with deep caries, it is necessary to remove the nerve, according to statistics, in less than a third of cases, and the extraction of the tooth itself due to deeply penetrated caries is generally a rather rare situation.
Prevention of deep caries
It is possible to avoid the development of caries deep inside the tooth if routine examinations at the dentist are regularly carried out and the appearance of the disease is detected even at the spot stage. With this approach, depulpation is highly likely to be avoided, and in the absence of latent caries, it will even be possible to do without opening the tooth and filling.
To prevent the appearance of even the earliest signs of caries, the following preventive measures must be observed:
- thoroughly brush your teeth at least twice a day - after breakfast and before bedtime;
- rinse your mouth after eating;
- Do not get involved in sweets and sweets;
- remove food debris stuck between the teeth;
- Avoid getting too hot or too cold foods and drinks on your teeth.
With a predisposition to carious tooth damage, you should consult a doctor and, on his recommendation, take calcium and fluoride preparations in the form of tablets or special solutions.
Chewing gums containing xylitol instead of sugar can be an additional preventive measure. They should be chewed for 10-15 minutes after eating to enhance saliva production and to clean the spaces between the teeth.
In combination with the systematic use, such preventive measures will provide reliable protection against tooth damage, and even with the first signs of caries, the doctor will be able to eliminate the pathology before it spreads into the deep tissues under the enamel.
Interesting video: preparation and restoration of a tooth with deep caries
An example of a two-stage deep caries treatment technique
Generally speaking, there is no such nosology as hidden caries in medical reference books and encyclopedias. Although the dentists themselves and their patients by this term ...
The simplicity or, conversely, the complexity of the diagnosis of caries directly depends on its location on the teeth and stage of development. Consequently, from the stage, ...
The decompensated form of caries is, in fact, an intensively developing caries, a pathological process that is very active in solid ...
Well, tin with this caries.
How to treat?
Nightmare. I'm afraid to go to the dentist. Already four teeth fall apart.
After giving birth, my teeth began to darken, and now two teeth are falling apart. I am terribly afraid to go to the dentist.
Now you can be treated under sedation, this is not particularly harmful. After administering the drug into a vein, you will almost fall asleep like a baby ... If you have very painful procedures, then don’t even remember what happened. And if you just put the seal, you will be in a very relaxed state, completely without fear. And for anesthesia, you will get a regular injection into the gum.
Oh, what a horror of this caries! Brrr ...
I have problems with my teeth, but still I will go to the dentist, especially since I found a good clinic. This is better than losing your teeth.
Where is the clinic located?
It’s scary when you don’t even suspect him, and then you go to the doctor, and 70% of your tooth is rotten inside. Yes, and why be afraid? After anesthesia, there are no sensations at all. Even when a metal pin is inserted into the root.
I’m very afraid to go to the dentist, the tooth is almost completely eaten by caries. I don’t know what to do, but I still won’t go to the dentist.
Hello Maria! This is not the most reasonable decision, because a tooth destroyed by caries can sooner or later begin to cause severe pain, and often - cause a "flux". At my appointment, people very often regret that they did not arrive on time, because it is much easier to treat a tooth when there is no edema near it. Of course, now everything is done with anesthesia, the procedures are painless. Therefore, your fears are in vain, there are more good doctors than you think.
Unfortunately, not everyone is painless. It’s even painful for me to treat simple caries with an injection of ultracaine. I am terrified of what will happen when the nerve is removed. I remember a moment from childhood, when they removed it to me alive, without an injection, and arsenic did not work at all. And since frost affects me badly, it turns out that with an injection it will be oh how unpleasant it is to remove the pulp. Hence the fears.
Oh, I also remember a childhood nightmare when my nerve was removed and arsenic didn’t work. And now I try to visit the dentist often and treat immediately at the stage of mild caries, without waiting for serious problems and pain. Still, in childhood I suffered, terrible memories and prompted to go rather to the dentist)
Depends on the drug. When they give me an injection, they don’t take it either. And when they do it in a private clinic, they immediately set their teeth. They have some imported drugs.
And I, rather, fear that I don’t have enough money for quality treatment! )))
Guilt in most cases in untimely treatment? Here is how you explain the situation that I went to the dentist every six months for preventive examination, asked to pay attention to the dark spot of the tooth, asked if it should be treated? What they told me - no, everything is fine, nothing suspicious, like this spot is pigmented ... And, lo and behold! 9 months after the first examination, the doctor says that this tooth needs to be treated and there is probably deep caries. I gouged a half tooth! And so with each doctor - they themselves do not know whether it is a pigmented spot or caries, until you force them to pay attention to the problem. As for me, any black spot is a caries, but no pigment spots!
Hello! I will say this: a dentist in a budgetary institution is often not configured to analyze spots on the subject whether it is pigmented or not (there is little time for one patient, no equipment, low motivation, etc.). Secondly, in many private clinics you will be spotted with spots of any origin, it does not matter if they are carious or not, how many there will be and how many teeth will be needed for this work (the more the better). Moreover, more than half of this will turn out to be age spots, but for prevention (so that nothing comes out and for greater benefit) they will also be sent for treatment. Only the patient will be sure that tooth decay was on all teeth.
Thirdly, the procedure for staining stains to determine caries takes considerable time and generally requires a separate group of specialists - hygienists. These specialists were prepared specifically for professional work, but most of them turned out to be released and not needed: they didn’t take a job, they needed a crust of a dentist, dentist, surgeon, orthopedist, etc., but not professional work - such urgent retraining. If there is no prevention trend in the country, then why will budget specialists begin to disassemble tooth decay or not, if: 1) they often do not pay or pay a penny; 2) the doctor has a lot of work with already formed caries and its complications.
And private traders, on the contrary, are ready to cure even pigmented plaque, like caries. How much I complained about them - do not count. And in conclusion, I’ll say that a black spot may well be caries, but there is also pigmentation, a “smoker” (conventional name), fluorosis, tartar, and chemical enamel necrosis, etc.
Will they drill a tooth with a very small hole?
Hello! You are talking about a rather pronounced violation of the integrity of the enamel, so the ICON technique (that is, tooth treatment without “drilling”) is not suitable in this case, since it is used for a carious spot when the enamel has not yet collapsed deep.Accordingly, only preparation with a drill is appropriate in this case. But you should not be afraid of this procedure, since enamel treatment with boron is carried out only a few minutes, under anesthesia and with an important goal: to rid the tooth of carious tissues strewn with bacteria that dissolve it. So look for a good dentist and a successful appointment!
My fifth tooth decayed, launched, since childhood, the fear of dental treatment. The tooth does not hurt. Got courage, went to a paid clinic. The dentist, having looked at the tooth picture, said that something could be done. And the orthopedic doctor, having looked at the tooth and poked at it with a piece of iron (I apologize, I write simpler, without sarcasm), said that the tissues are soft, it is better to remove them, because money will simply be wasted (treatment, pin, etc.). I believed him, because when poking, I felt that the tooth was soft as if. Now I’m thinking ... Go immediately surrender, delete, or, perhaps, somehow save. Question: can I do something? And more ... For those who are afraid, shy and pulling with rotting teeth. Do not delay, go at least for a consultation, and it will be easier for you. As the dentist told me, "caries itself does not go away."
Hello! I'm afraid that you are faced with a situation when it comes to the so-called “controversial tooth”. Unfortunately, it so happens that the opinions of a number of experts on the same case can be substantially divided. You can go through a consultation with another 2-3 dentists in different clinics (the benefit is that it is almost always free, if primary) and understand which point of view prevails.
Without seeing the condition of your tooth, only by description alone it is impossible to render a verdict in absentia, although in general the problem is clear. In fact, tens of thousands of teeth that could be preserved are removed annually in Russia, and about the same are preserved without the prospect of a long-term existence. These are the realities of life - it is not always possible to “stick” indications to one or another action (to treat or remove) for various reasons, ranging from the patient’s strong desire to remove a tooth even with a small caries or pulpitis and ending with a lack of desire from the dentist or equipment (materials) for tooth salvation.
I can say for sure that if the dentist and orthopedist work in the same clinic, you should not push them with their foreheads. It is better to contact a couple of other clinics and form a general idea. A large number of votes for tooth extraction will convince you to get rid of it without any particular worries (and regrets in the future), and dentists will tell you what is best for the price-quality criterion to replace it. With a minority of votes, you will know how to preserve the tooth in the best way so that it continues to serve for many years.
From my personal experience. At the dentist was ... I don’t even remember when. Yes, yes, it was the same FEAR. Despite the fact that I saw with the naked eye and with my mind I realized that I was relentlessly launching my teeth. Once the tooth wall broke off and had to make an appointment. For the first time, fear shook the whole body and voice, the heart almost jumped out of the chest. Bottom line - 14 teeth with caries were found, one tooth whose wall broke off had to be removed, since there was already nothing to save. And a lot of money and nerves spent, and the devil knows how much remains to be spent. But dental treatment is completely painless. Do you hear? PREVIOUSLY. Now in my fourth decade I understand how I did wrong, bypassing dentists a thousand kilometers. Now there is no fear, calmly and comfortably, I sit down in a chair and worry only about being able to save what is. Now there is only one fear - if only there would be enough money for treatment. Just kidding. I’ve been treating for the third month, I have been carefully collecting receipts so that I can further deduct a tax deduction ... But all this could have been avoided if I had consulted a doctor many years ago ... But alas, this is already impossible.So sort out the first fear. Make sure that there is no pain at all, and then, believe me, it’s already much easier, and the dentist becomes more familiar than anyone in the world. Good luck.
Alas, everyone has different ways. Local anesthesia has almost no effect on me. Well, unless after the 10th injection, and then from these injections for two weeks the whole mouth will be swollen.
My tooth is rotten, the pain is terrible, around the swelling below ...
Hello! Apparently, in your case we are talking about a purulent process that can characterize acute periodontitis, periostitis, abscesses, etc. If there are indications for tooth extraction, it should be urgently removed in order to avoid further infection progression in the maxillofacial spaces (otherwise the situation can worsen significantly, up to sepsis - blood poisoning). If we are talking about periodontitis, then the tooth can often be saved. It is important to consult a doctor in time and make a diagnosis in order to promptly remove the source of purulent infection: this often does not mean tooth extraction, but it is a phased treatment of the tooth canals with subsequent filling and restoration of the filling, or tab, crown.
Hello, two months ago I had a seal reinstalled in a paid clinic, my nerves were removed a long time ago. The doctor put a seal for me, and when he did it (by the way, without canceling the canals and putting the seal - he decided so), it felt like he put something that expanded my tooth, and then tried to squeeze it. I was so scared that I jumped on the chair. At home I found that the tooth was cracked - slightly, but along the entire length. A week later, the smell and taste of rot appeared. I was afraid to eat with this tooth. After another two weeks, a piece of tooth fell off, and sometimes in the morning it hurts, sometimes there were severe pain at night. And now, I'm still going to snatch him. Just do not understand why it happened ...
I have a bad situation with all my teeth, although I brush twice a day, and rinse after eating, remove pieces. Caries on all lower teeth, somewhere in the outside of whole teeth is hollow (I'm 20).
Hello! Judging by the description, the complication was most likely due to the fact that the doctor violated the rules of tooth restoration. Or he didn’t take into account the indications for its restoration - perhaps, orthopedic treatment was required, but not filling.
Regarding the progressive decay of teeth by caries at age 20: as you know, plaque plays a key role in the development of the carious process. Accordingly, you do not brush your teeth on all surfaces. Very often, the teeth begin to decay first in the cervical area, where plaque accumulates, especially on the contact surfaces (between the teeth), when a lot of food gets into the spaces between the teeth, and it stays there, “rots”. The chewing surfaces of the teeth, where there are pits on the teeth (fissures), are also affected, from where the food is difficult to clean.
It is not so difficult to clean the interdental spaces: dental floss or irrigator will help you. The caries that have already formed will not disappear from good hygiene - treatment of these teeth is required, and the sooner the better. But the prevention of caries on healthy teeth is important to carry out. I recommend getting a dentist in-person consultation on this subject - it is possible that in your case there are additional prerequisites for the rapid destruction of teeth by caries.
And I would advise one thing - completely stop eating sugar. At one time, only this helped me. And from brushing my teeth it was pretty little, honestly.
Recently I filled a tooth (a month ago), yesterday, purely by accident, I discovered a black vertical crack on the side. Should I go again to treat the same tooth? And why then the doctor did not do anything with her?
Hello! The fact is that some dentists sometimes either ignore small pigmentations, which can only theoretically be a carious spot, or simply do not notice the problem areas in the process of inattention.
Since according to your description it is not clear what a “black vertical crack” is and how dangerous its presence is for a tooth, I recommend that you contact your dentist again (preferably another doctor). And already then purposefully find out whether it is worth making any intervention.
Yes, as these doctors were konovalov, they remained! Today I lost thanks to them another tooth, and just broke off together with a light-curing seal! Moreover, the quality of the light-cured material is high, it almost did not grind for about 7-10 years of standing in the tooth. Immediately clear - bourgeois, not made by our "fins". But, damn it, our doctor 7 years ago (I don’t remember exactly, maybe all ten have passed) when I installed this seal, I just stupidly cleaned my tooth from tooth decay! And here is the result - during these 7-10 years, the tooth slowly decayed from the inside, without pain and imperceptibly. And broke off in the end, along with a super-class seal - and now I lost my next tooth because of our fool doctors (well, or little fools)! Moreover, I never spared money on dental treatment and always went to paid doctors. Recently, I looked at my mouth in the mirror and saw that almost all of my filled teeth have dark spots - and this, their mother, these doctors, means that all of them, with a few exceptions, did not clean the tooth cavity well before installing the fillings!
Hello! If we are talking about darkening on “live” teeth, then yes, the carious process can also develop under an insufficiently established seal.
Plus there is still such a moment (more common): after depulpation, the tooth itself can darken + becomes brittle, because its tissues no longer receive nutrition. That is why the best option for working with depressed teeth with thin walls is restoration using the tab + crowns, and not filling with photopolymers, even with pins. Let it be a more expensive option, but with the high-quality performance of manipulations on the technical part, the tooth can be saved for 15 years or more.
Good afternoon! Dark stripes on the teeth - should they be treated, or is it a “patient whim”? The doctor said nothing ... I was treating two teeth, he said that there were no more holes))
Hello! If it is caries, then it is definitely required to treat teeth. If pigmentation or non-carious lesion, then decide at your discretion, since the decision (or not the solution) of aesthetics issues largely depends on the person himself. Contact another dentist, and to know for sure, you can get 2-3 independent opinions, which will give additional confidence in further actions.
Hello, I'm 11 years old. A toothache, I decided to read. In the evening, the tooth does not hurt so much. So, I read it and it’s scary now to go to the dentist. But I do not want to lose my teeth.
Hello! Today, almost all procedures are performed with anesthesia. That is, treatment in most dentists is carried out painlessly. The only difficulty is finding a good dentist with quality equipment. But the best way is to go to the doctor whom your relatives, friends and acquaintances turn to, happy with his work. This is how you can find your dentist, make friends with him, since you will have to apply for a long life regularly with different situations - this will help to keep your teeth to old age.I recommend doing this as soon as possible, since at your age the teeth are almost always permanent, and with regular pains we can talk about complications of caries, which is often one of the reasons for tooth extraction.
In some clinics they do this procedure - before treatment, you inhale a certain amount of “laughing gas” through the mask, and you feel so good and calm that you will not be afraid of anything. The main thing, of course, is that you have no contraindications, but it is the doctor who decides after the examination, based on the state of health and the presence of some other diseases.
Hello, and with what means can you kill the bacteria that cause tooth decay? For example, I rinse my mouth with water and salt or soda, or hydrogen peroxide diluted in water, or furatsilinom. Does rinsing my mouth kill bacteria or not?
Hello! These methods are practically ineffective, since it is scientifically proven that tooth decay occurs under plaque, which requires mechanical cleaning. Antiseptics can partially suppress the activity of bacteria in the oral cavity, but under dense plaque, it will not be possible to destroy all bacteria. Plaque must be “moved” with a toothbrush, and the contact surfaces of the teeth require special care: the use of dental floss or irrigator. Hydrogen peroxide is an aggressive agent and is for professional use only, as it can cause mucous burns if used improperly.
To ensure a truly effective prevention of caries, you should first contact a dentist and conduct professional oral hygiene (cleaning from stone and plaque), and then at home, maintain a high level of hygiene with a toothbrush and toothpaste, which the dentist will choose according to existing problems. If with gums, then to remove the inflammatory process of the gums; if with carious foci, then after treatment of caries - therapeutic and prophylactic with fluoride; if sensitive teeth or enamel abrasion - paste, with a reduced content of abrasives ("for sensitive teeth"). And the fact that you rinsed your mouth partially suppresses the microflora, but it often harms more than helps solve problems.
Buy a Sivak wand ... Kills bacteria, within 2 hours they are gone.
A seal flew out, and under the seal everything was black. And the tooth wall is loose, but there is no pain. On some teeth on one side there are black dots and in large numbers. What to do about it?
Hello! With a high degree of probability, a caries relapse under the filling, that is, there are carious tissues. Almost always, wall fracture is associated with the fact that the tooth is “dead” and has a strong carious destruction. If the tooth was previously depulped, then a picture is needed to diagnose a possible inflammatory process and the quality of filling the canals. If the tooth is “live”, it is often enough to check the degree of tooth decay to decide whether to remove the “nerve” or not. Often, the doctor is inclined to remove the nerve, and since you have already been treated for caries, a second time to fill the seal without canal treatment may no longer be possible.
On the remaining teeth, I’m almost sure that there are also carious lesions, since the black dots that you write about usually indicate exactly this (much less often, pigmented spots). I am sure that you need urgent treatment of caries, but the tactics of treatment will be determined only by the doctor after carrying out diagnostic measures.
Good afternoon. I wanted to ask, is Ultracain really so good?
Hello, Victor! Ultracaine in dentistry is used in a variety of procedures, including surgical interventions (the drug really has a high level of analgesia due to its composition). However, no matter how safe this anesthetic is, in comparison with analogues, it still has its own contraindications. Therefore, if you have intolerance to certain drugs, you should definitely notify your doctor in advance.
Hello. The tooth with the seal collapsed and darkened in a month. Now the tooth began to hurt and the gum was inflamed. Two sides of a tooth are destroyed, while the third also began the process of destruction. The fact is that I am 9 months pregnant. I do not know what to do…
Hello, Elena! In the 3rd trimester, additional stress in the dentist's office is extremely undesirable. If possible, it is better to postpone dental treatment for the period of lactation (feeding). However, this does not apply to emergency cases, for example, acute toothache. So if the tooth is very sore, then you still need to contact the dentist for diagnosis and subsequent treatment of the tooth.