Cavity

About Cavity Treatment

What is tooth decay?

The condition in which teeth are dissolved by the acid produced by the mutans streptococcus bacteria that causes tooth decay is called “tooth decay.”
The initial symptom of tooth decay is demineralization of the tooth surface. At this stage, it is possible for the cavity to be cured by remineralization, but generally, cavities do not heal naturally, and once a cavity has developed, treatment such as drilling and filling is required.

Tooth decay will not heal naturally and the tooth will not return to its original state.
Treatment involves removing areas affected by cavity-causing bacteria, filling in the dissolved areas, or placing a cap.

Basically, once you have tooth decay, it is impossible to reverse the disease, so early detection and treatment are important. For that reason, it is very important to take preventive measures such as regular checkups, use of fluoride, and professional cleaning.

Causes of tooth decay

Why do we get cavities?
The occurrence of tooth decay is largely dependent on the following factors: teeth, tooth decay bacteria, sugar, and time.

When all these factors occur at the same time, tooth decay occurs.

There are some people who have almost no cavity-causing bacteria in their mouths, and these people do not get cavities even if they skip brushing their teeth a little.
Even people who are prone to cavities are less likely to get cavities if they are careful, avoid sweets, and make it a habit to brush their teeth immediately after eating.It is also important to use fluoride frequently on a daily basis to strengthen the quality of your teeth.

About tooth decay pain

Why do teeth hurt?

“Why does cold food sting? Why does eating chocolate hurt?”

The reason why tooth decay causes pain is due to the nerves inside the tooth. Let’s start by looking at the structure of a tooth.

The white part of your teeth that you see in your mouth is the hard, inorganic enamel that covers the surface of your teeth. Inside the enamel is the soft, organic dentin, which contains the nerves of the teeth.
When tooth decay progresses beyond the hard enamel, it spreads rapidly through the dentin, which has no resistance to decay.Enamel is like armor for teeth, protecting them from decay.

If you look at dentin under a microscope, you can see that it is filled with countless tiny holes.
These are thin tubes called “dentinal tubules,” and dentin is made up of a collection of these thin “dentinal tubules.” The inside of the dentinal tubules is filled with liquid, and when the liquid inside moves due to stimuli such as differences in osmotic pressure, it transmits stimuli to the nerves of the tooth, and when this is transmitted to the brain as sensations such as toothache or toothache, people feel pain.

Cold drinks and sweet foods such as chocolate can also irritate the tissue fluid inside the dentin tubules, causing pain.

Consideration for pain during dental treatment

Dental treatment involves drilling out cavities and extracting teeth. The human body senses pain in response to such stimuli to let us know that something is wrong with the body.

Dental anesthesia makes it difficult to feel pain, allowing dental treatment to be performed without discomfort. If the nerve inflammation is severe, anesthesia may not be effective, so in that case additional anesthesia will be administered to proceed with treatment without pain.

Consideration of pain during treatment

When we grind down a tooth that has a nerve, we always use local anesthesia. (Of course.)
※If you have had any allergies to anesthesia in the past, please let us know in advance.

Before anesthesia, a topical anesthetic is applied and then the anesthetic solution is slowly injected.
We use thin anesthesia needles and take great care to minimize pain for patients during treatment.

■ Topical anesthesia

In general dental treatment, it is not uncommon to inject anesthesia with a needle immediately. However, depending on the location of the injection, you may feel pain when the needle is inserted.

Therefore, at our hospital, we are able to reduce the pain of needle anesthesia by applying a topical anesthetic (sometimes referred to as ointment anesthesia) to the area before administering the needle.

Topical anesthesia works by applying it to the mucous membrane of the gums. The mucous membrane absorbs the anesthesia very quickly, so a mild numbness occurs in about 3 minutes. (For those who are quick to respond, the effects may be seen within 1 minute.) The anesthetic is then injected.

■ Electric anesthesia machine

Before any procedure that requires anesthesia, we always administer a topical anesthetic to reduce the pain of the anesthetic needle being put in. In fact, many patients feel pain from anesthesia not at the moment the needle is inserted, but when the medication is administered.

At our hospital, we always inject with enough pressure so that patients do not feel any pain, thereby reducing not only the pain of the needle but also discomfort during the anesthesia.

■ 35G thin needle

Many people dislike the needles used for vaccinations and blood draws because they seem to be very painful. The needles we use at our clinic are 35G thick (0.23mm), which is very thin compared to the needles used for vaccinations and blood draws (generally 0.45-0.7mm), so there is less pain when they are inserted and the amount of liquid medicine injected is small and slow, making it less painful.

■ Mandibular foramen
conduction anesthesia

At our clinic, we sometimes use an anesthesia method called “mandibular foramen conduction anesthesia” when extracting wisdom teeth. In general, the bones of the lower jaw are very hard, making it difficult for the anesthetic solution to penetrate and for the anesthesia to work. This anesthesia method directly anesthetizes the area near the nerve that is the source of the pain, so even patients who are resistant to anesthesia can have their pain reduced and undergo tooth extraction and treatment.

■ Courteous service

One factor that makes you more sensitive to pain is that you may become more sensitive to pain when you are under extreme tension.

In order to reduce such tension, at our hospital we actively create an environment in which patients do not come to treatment feeling even the slightest bit anxious by providing sufficient explanations before surgery, asking questions, and obtaining consent.

If you have any fears or anxieties about dental treatment, please feel free to contact our clinic.

Consideration of
post-treatment pain

On the day of treatment, you will be given pain medication to help with pain after the anesthesia wears off. Please be sure to take it.
You may still experience pain for 2-3 days after treatment, so be sure to take painkillers for a while and monitor the condition.
If the pain after treatment is very severe, it may not go away unless the nerve is removed, so if this happens, please contact the clinic immediately.

Treatment that preserves nerves as much as possible

There are several stages of toothache caused by cavities. The initial symptom is that cold foods start to sting. If the cavity progresses a little further, warm foods start to sting as well. If it is still at this stage, in many cases it is possible to treat the tooth while leaving the nerve intact. If you experience symptoms such as your tooth hurting from the vibration when going down the stairs, your tooth hurting when you sleep at night, or your tooth throbbing even when you are not doing anything, then the cavity has progressed quite close to the nerve and in many cases the nerve will need to be removed.

The basic idea is to leave as much nerve tissue as possible intact.
Removing the nerve increases the risk of bacteria invading the inside of the tooth, which can significantly reduce the lifespan of the tooth. If you are experiencing severe pain, the pain will not go away unless you remove the nerve, so you have to remove the nerve, but it is better to leave the nerve intact as long as possible.

The progression of tooth decay

C1：Decay within the enamel
This is the early stage of tooth decay, which occurs within the enamel on the surface of the tooth. There is almost no pain or symptoms, and the surface of the tooth has turned white, the grooves have turned black, and there are small holes. Treatment involves scraping the tooth a little and filling the area with resin (plastic).
C2：Decay that has reached the dentin
Cavities that have penetrated the enamel and into the dentin are called C2. Dentin is mainly made of organic matter and decay progresses very quickly.
Symptoms of tooth decay at this stage vary depending on the size of the cavity. Symptoms include sensitivity to cold, sweet, and hot foods.
Depending on the location and size of the cavity, treatment will involve either filling the cavity with resin (plastic) or taking an impression of the tooth and creating a partial filling called an inlay or onlay and attaching it to the tooth. About cosmetic dentistry
C3：Decay that has reached the tooth pulp (nerve)
If the decay progresses further, it will reach the nerve and cause severe pain. At this stage, the symptoms will not improve unless the nerve is removed, so root canal treatment is required. Removing the nerve of the tooth causes considerable damage to the tooth, so treatment is carried out in a way that preserves the nerve as much as possible.
C4：Decayed teeth with lost tooth structure
This is a state where a tooth has been lost due to decay, and only a worn-out tooth root remains. Teeth without nerves or where the nerves have died do not feel pain even if the decay progresses, so by the time you notice it, it may have already progressed to C4. In most cases, the treatment is extraction.