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“Hollow”, a hole in the tooth, as soon as they do not call the carious cavity. But regardless of the name, this is a problem that requires treatment and it will not go away on its own. Enamel, dentin and cementum of the root of the tooth are mineralized tissues that are unable to repair themselves. And if there is no treatment, then the cavity only increases.
What is a hole in a tooth
Each tooth is covered with enamel – the most durable mineralized tissue of the human body, which withstands daily chewing load, which is several tens of kilograms per square centimeter. It is enamel that protects against physical, thermal and chemical irritants.
Below the enamel is dentin – the main substance of the tooth, which has a tubular structure. Compared to enamel, dentin is less dense and is destroyed much faster under the influence of a number of factors.
The destruction of enamel prisms and dentine tubules leads to the formation of a cavity, in other words, a hole in the tooth.
Why holes appear in the teeth in adults
Despite the fact that enamel is a strong mineralized tissue, it can be destroyed under the influence of aggressive factors. The most common cause of cavity formation is caries.
Caries-forming bacteria secrete a number of acids, for example, pyruvic acid, which contributes to demineralization, that is, the uncontrolled release of minerals.
Caries is a staged process, first the subsurface layer of enamel is affected and, if the process is not interfered with, then caries passes to dentin, a softer substance. The destruction of dentin is hidden under the enamel, so this process can go unnoticed for a long time.
Many have noticed that a dark spot has appeared on the tooth, or the enamel becomes gray, because a cavity has already formed inside, which is translucent. Over time, this cavity grows, the dentin collapses, depriving the enamel of its support, and sooner or later it will chip, and the cavity will be exposed. Sometimes patients who come to the dentist say that everything was fine yesterday, but today there is a hole in the tooth.
Large carious cavities often indicate pulpitis, when caries has already penetrated deeper than the dentin into the pulp (“nerve”). If pulpitis is not treated, periodontitis develops – a condition when the process already goes beyond the tooth into the surrounding tissues.
Another possible reason for the formation of a cavity is non-carious lesions, for example, a wedge-shaped defect. This is a pathological process in which a wedge-shaped cavity is formed in the cervical region of the tooth, and the cause is more often hidden in bite pathologies.
What to do if an adult found a hole in the tooth
When dark spots appear, changes in the color of fissures (natural depressions on chewing teeth) and even more so a carious cavity, the first thing to do is to visit a dentist.
Caries will not be cured on its own, and if you delay, the problem will only progress. Even if pain appeared and after a while it passed, this does not mean that the disease is gone. This is not a reason for joy, on the contrary, it is evidence of the transition of the main cause into complications.
There are no tablets, pastes that will restore the enamel. To stop the process and prevent tooth loss is possible only through dental treatment.
How adults treat holes in their teeth
The main goal of dental treatment is to remove the tissues affected by caries and restore the anatomical integrity of the tooth. What can be done by several methods, which can be conditionally divided into therapeutic and orthopedic.
Therapeutic treatments. This is a classic preparation (“drilling”) of the cavity in order to remove the affected tissues, overhanging edges of the enamel. After the formation of the cavity, it is treated with antiseptics to destroy the pathogenic microflora. This is followed by the stage of filling in order to restore the anatomical integrity of the tooth.
Modern dentistry has a wide range of composite materials that meet all the requirements: withstand chewing load, transfer tooth color, allowing cosmetic restorations, even if these are front teeth.
Despite all the versatility, if the hole in the tooth in adults is large, filling may be contraindicated. This can be explained by the fact that the filling may not withstand chewing pressure, and this increases the likelihood of chips, crown fractures and even tooth loss. Depending on the degree of tooth decay and the size of the carious mouth, orthopedic treatments are recommended.
Orthopedic methods of treatment. When forming an extensive cavity, the dentist may recommend the installation of an inlay or the manufacture of a crown.
The inlay is a micro prosthesis. It is made in order to restore the anatomical integrity and shape of the tooth, in other words, this is the same restoration method, but it is more durable and able to withstand chewing load compared to filling. Greater strength is due to the fact that it is a monolithic structure, one-piece, and the filling material is applied in portions and stacked in layers.
The inlays are machined from a special monolithic block, and if the clinic’s equipment allows, then the whole procedure takes about an hour. By the way, digital technologies make it possible to abandon the classic taking of casts and replace them with digital methods. With the help of an intraoral camera, a digital impression (photo) of the oral cavity and tooth parameters is taken. A digital model of the jaws and parameters of the future inlay are formed in the computer program, which eliminates the human factor. The whole procedure is carried out in one visit, although earlier, this treatment was stretched for several days and even weeks.
Another advantage of inlays is their strength, they are not subject to abrasion, unlike filling materials. Over time, fillings can wear out, become flat, change the occlusal height of the bite, and even clicks, crunches or pain in the temporomandibular joint can occur, so it is so important to restore the anatomy correctly, even if it is just one tooth.
With a significant destruction of the tooth, when even when installing the tab, the probability of breaking off its walls is high or it is difficult to fix it, the manufacture of crowns is shown. This “cap” covers the tooth completely, which will protect it from further destruction.
The material for the manufacture of crowns is selected individually and depends on the group of the tooth.
Important! When deciding which method of treatment to choose, dentists use a special index IROPZ (index of destruction of the occlusal surface of the tooth). Based on its indicators, it becomes clear which method of treating a hole in a tooth is acceptable: a filling, an inlay, pin-stump structures, crowns.
Prevention of holes in the teeth
Given that the main cause of the appearance of a cavity in the tooth is caries, appropriate methods of prevention are recommended. Firstly, it is a high-quality and complete cleaning of the teeth using basic and additional tools and hygiene items: brush, paste, floss, irrigators, etc.
Secondly, compliance with all the rules of brushing your teeth and the use of additional tools and hygiene items.
Thirdly, these are regular preventive examinations in the dentist’s chair. As part of these procedures, enamel is remineralized, that is, it is saturated with minerals. They detect caries and other diseases in the early stages of development, therefore, the treatment is easier and painless. And, of course, they eliminate the main cause of caries and gum disease – dental deposits.
Popular questions and answers
Caries and its complications, as the main cause of a hole in the tooth, is a common disease. According to WHO, 99% of the world’s population has at least one carious tooth. Therefore, the problem of destroyed teeth is the everyday life of dentists. She told us about possible complications and consequences and alarming symptoms Candidate of Medical Sciences, Dentist, Implantologist and Orthopedist, Associate Professor of the Department of Dentistry of the Central State Medical Academy Dina Solodkaya.
The situation is more complicated with the diagnosis of cavities on the contact surfaces, that is, between the teeth. Visually, these cavities are invisible and only with a thorough examination by a professional, and often only in a three-dimensional image, can they be identified. But to assess the extent of the problem, visual methods of examination will be needed: CT, visiography, and, in extreme cases, radiography. Therefore, it is so important to visit the dentist regularly for the timely diagnosis of caries.
The main and, perhaps, the most frequent complication is the chipping of the tooth walls, the destruction of the crown. Such teeth are difficult to restore. It will take a lot of time and money. Fuel is added to the fire by the presence of periodontitis, periostitis, cysts of the teeth, which in some cases may be an indication for removal with subsequent implantation.
However, there are a number of warning signs that should promptly visit a doctor:
● toothache;
● the appearance of persistent putrid odor from the mouth;
● the formation of an extensive cavity, even if the tooth does not hurt;
● formation of edema, redness on the part of the diseased tooth;
● sensation of a grown tooth, pain when biting, and even more so its mobility.
The above symptoms are signs of acute conditions that pose a threat to the patient’s health. And the sooner the treatment is completed, the higher the chance of success and preservation of the tooth.