Fissures are little dimples or notches on the tooth surface. Some teeth have
peculiar distinct fissures which are very narrow and very deep. As a result it
is not possible to clean them with a normal toothbrush. Consequently the risk
of developing tooth decay increases, as you can see on the picture below:
The
chewing surfaces of the back teeth are not smooth, as other areas of your teeth
are. Instead, they are filled with tiny grooves referred to as “pits and
fissures,” which trap bacteria and food particles. The bristles on a toothbrush
can’t always reach all the way into these dark, moist little crevices. This
creates the perfect conditions for tooth decay.
There are often no symptoms of
cavities, which is why important of visiting a dentist so that cavities can
be diagnosed and treated early before they get large enough to cause symptoms. Early
in its development, caries may affect only enamel. As the cavity progresses,
the decay gets near the nerve (pulp) and can cause pain, which gets
progressively worse especially with exposure to heat, cold, sweet foods or
drinks. If the decay gets large enough, part of the tooth may fracture off,
leaving a large visible hole, and the tooth may be sensitive to biting
pressure. Bad breath and or a bad taste in the mouth are also symptoms.
The tip of a dental explorer, which is used for caries diagnosis.
A person experiencing caries may not be aware of the disease.The earliest
sign of a new carious lesion is the appearance of a chalky white spot on the
surface of the tooth, indicating an area of demineralization of enamel. This is
referred to as incipient decay. As the lesion continues to demineralize, it can
turn brown but will eventually turn into a cavitation (“cavity”). Before the
cavity forms, the process is reversible, but once a cavity forms, the lost
tooth structure cannot be regenerated. A lesion which appears brown and shiny
suggests dental caries were once present but the demineralization process has
stopped, leaving a stain. A brown spot which is dull in appearance is probably
a sign of active caries.
As the enamel and dentin are destroyed, the cavity becomes more noticeable.
The affected areas of the tooth change color and become soft to the touch. Once the decay passes through enamel, the
dentinal tubules, which have passages to the nerve of the tooth, become exposed
and causes pain in the tooth. The pain may worsen with exposure to heat, cold,
or sweet foods and drinks.
Treatments for cavities include
fillings, crowns and root canals. If the lesion is very small and just
beginning, it can be treated with fluoride paste and varnish to help stop the
progression of the demineralization. If the cavity is formed, however, there is
only one option: to remove the decay and put a filling in its place.
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Classification
of caries
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Grade I (incipient):
Surface
texture: Soft, can be penetrated with a Dental Explorer;
No surface
defect;
Pigmentation:variable,
Light tan to brown
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Grade II (shallow) :
Surface
texture: Soft, irregular, rough can be penetrated with a Dental Explorer;
Surface
defekt: (<0.5 mm in depth);
Pigmentation:variable,
Light tan to brown
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Gingival
recession
(receding gums) is the exposure in the roots of the teeth caused by a
loss of
gum tissue and/or retraction of the gingival marginfrom the crown of the teeth. Gum
recession is a common problem in adults over the age of 40, but it may also
occur starting from the teens.
In healthy teeth, enamel protects the
underlying layer of dentin, which is softer than enamel. The tooth roots are
protected by gums. But if the enamel is worn down or if the gum line has
receded, then the dentin becomes exposed. Dentin contains thousands of microscopic
tubules, or channels, leading to the tooth's pulp. When exposed to the
elements, these dentinal tubules allow heat, cold, acidic or even sticky
substances to reach the nerves inside the tooth, causing pain.
Symptoms:The roots
of the tooth are exposed and visible .The tooth feels notched at the gum line.
Causes: Overaggressive
brushing, which causes the enamel at the gum line to
be worn away over time by scrubbing the sides of the teeth in a washboard
fashion.
Treatment
should start with addressing the problem(s) that caused the gum recession. If
overactive brushing is the cause, the patient should consider purchasing a
softer toothbrush and use a more gentle brushing technique. If poor plaque
control was a contributing factor, improved oral hygiene must be performed,
combined with regular professional dental cleanings as prophylaxis. If severe
calculus (tartar) was the cause, then a procedure called
scaling and root planing may be necessary to clean the teeth and heal
inflammation in the gingiva (gums).
