|
|
The Deep Cavity: To Fill or Not to Fill?
When a patient comes to a dentist with a deep cavity, the dentist hopes to be able to fill the cavity without the need for a root canal. To understand how a cavity affects the tooth, we need to have a basic understanding of its anatomy. A tooth is composed of several layers. The outermost layer, above the gum line, is called the enamel.
Enamel is the hardest and most mineralized substance in the body. Beneath the gum line, a substance called cementum covers the tooth roots. Under the enamel and cementum is the dentin. The dentin is about as hard as bone, and, unlike the enamel, dentin contains nerve endings.
Beneath the dentin is a vascular tissue called the dental pulp. Unfortunately, a deep cavity increases the likelihood that the tooth will require a root canal. The reason is that a cavity is actually a bacterial infection of the tooth, and if bacteria reach the dental pulp, a root canal is usually required.
Here’s the problem. If a deep cavity is filled, and there is no visible evidence that the pulp has been infected, the tooth might still need a root canal days, weeks, months, or even years later. There are two possible reasons why this can happen. The first is that bacteria can actually enter the pulp via microscopic openings in the dentin surrounding it. The second is that the process of drilling the cavity out could damage the pulp unintentionally, which then needs to be removed during root canal.
This puts the dentist in a “catch-22” situation. If the dentist leaves the deep cavity alone, the tooth will definitely need a root canal when the cavity eventually reaches the pulp. If the dentist fills the cavity, the tooth may still need a root canal at some point in the future. My feeling is that it is still better to fill the tooth, because there is also a good chance that the tooth will never a need root canal or any other treatment.
Although this scenario may sound like a no-win situation, there are some things that you can do to prevent cavities from forming in the first place. The easiest way to avoid cavities is by brushing your teeth at least three times a day, especially after eating and before bed. Flossing at least once a day is important to remove plaque between your teeth. Reducing the amount and frequency of eating sugary foods can reduce the risk of forming cavities. If you are going to drink a can of sweetened soda, for instance, it is better to drink it in one sitting, than sip it throughout the day. Getting to the dentist at least twice a year is critical for examinations and professional dental cleanings.
|
|