As a patient, the most difficult part of having this kind of decay is actually not knowing that you even have decay in the first place.
This tooth is found at the back part of the mouth and even has an old dental filling sitting on top of the decay. Visibility-wise, it is really hard to notice this until there is pain. This patient was not even aware of how big the decay is until we removed the old filling. This is where the importance of going to your dentist regularly comes in, it will save you the hassle and additional costs if you can keep your decays at a minimum.
This is a case of tooth decay that extended deep within the tooth and slightly reached the pulp. The pulp is a part of the tooth made up of nerves and blood vessels located at the very core that gives life and nourishment to the tooth. Any decay, infection or injury very near a nerve will either cause intense pain or leave a tooth permanently numb if the decay has successfully killed the pulp already. And we don't want any of that.
This specific tooth is alive and well, albeit infected. Based on the signs and symptoms the patient showed, a composite filling is the dental treatment of choice both the patient and I agreed to do. The procedure started with putting anaesthetics to numb the tooth to ensure that the patient is comfortable throughout the drilling. Dental drilling to remove decay near the pulp are painful during removal, thus the importance of anaesthetizing.
The patient did not complain of any pain during and after the dental filling procedure. Since pain varies from person to person, this doesn't mean that just because this patient felt zero pain, everyone who gets their fillings done will also experience zero pain. Pain tolerance usually varies from person to person. Although the materials used in general is safe and effective, some people's body may still reject them like how some people have allergies to some generally safe food. In this case, luckily, it's been 5 months (as of writing) and no pain is still reported for this specific case.
One of the goals of filling deep cavities is protecting the pulp at all times. In situations like this where we can already see a part of the pulp exposed or only a thin part of the tooth protecting it is left after the removal of the decay, and the tooth condition still responds well, we usually place a medicine called calcium hydroxide inside to assist the tooth in healing.
Take note that a deep decay like this, despite having the tooth treated perfectly, may still eventually lead to different dental procedures like root canal treatment, dental crowns or extraction when the tooth finally gives up and stops healing.
You might ask, what is the sense of still doing a dental filling if it may lead to a bigger procedure someday? Why not proceed with the bigger procedure right away?
Well, as much as possible, we make our suggested treatment from the most conservative going towards an aggressive procedure. If filling this tooth will serve you 4 years, then you can use that 4 years to save up for the more aggressive and costly procedure. Or, if you're one of the few lucky people where dental filling survives a lifetime, then that will save you the hassle of going through an aggressive and more costly procedure.
Also, having a more aggressive procedure like root canal treatment still doesn't guarantee you a lifetime pass of not having any additional dental procedures for that tooth someday. My motto is to always keep it simple.
At the end of the day, it will still depend on you which route of dental treatment you want to take. After all, we are always here to educate you.
So, that's it about this case. I try to make the explanations as simple as I can so that all patients can understand. If there are areas that are still unclear, feel free to email me at dr.rafaelle@gmail.com or you can even book an appointment for a consultation if you have questions about your personal case. Take care!
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