What are the symptoms of tooth decay?
Early tooth decay (dental caries) is usually symptom-free. It is only when the caries has progressed deep enough into the dentine to cause one of the following scenarios that most people become aware that they have a dental problem:
- Caries spreads through the dentine, softening it significantly so that the enamel fractures and collapses to form a cavity, usually after biting on to something hard. Prior to this event there may be toothache or no symptoms at all. The edges of the cavity can be quite sharp and are often the main complaint when people attend for dental treatment
- The pulp becomes inflamed and irritated by the acid and toxins being released by the approaching bacteria. This is called pulpitis and causes the tooth to feel sensitive to hot or cold or sweet food and drinks. When the pulp has become very inflamed the tooth may become tender to bite on to - this is called periapical periodontitis.
In both these scenarios non-invasive treatment options are no longer suitable and a filling is usually required.
This is why regular dental check-ups are so important. The dental team is trained to identify early signs of possible tooth decay, such as chalky whitish or grey shadowy areas on the biting surfaces, or between the teeth, then recommend appropriate measures.
Advanced dental decay will usually cause the pulp to become severely inflamed and die. This is usually after a period of painful pulpitis but can occasionally happen in teeth that have felt little or no pain at all. When the bacteria have infected the pulp space they multiply and spread out into the bone at the end of the tooth root. This forms a periapical abscess which makes the tooth extremely painful to bite on to. Paradoxically, the pain may be relieved when sufficient bone has been destroyed to allow the trapped infection to drain away under the gum. The treatment for a periapical abscess is either root canal treatment or a tooth extraction.
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