Dental caries, commonly called cavities, are permanently damaged areas on the hard surface of teeth that become small openings. They result from bacteria in your mouth producing acids that eat away at tooth structure. If left untreated, these lesions can grow larger and affect deeper layers of a tooth, leading to pain, infection, and even tooth loss. The goal of caries removal is to eliminate the decayed tissue and restore the tooth’s form and function.
Diagnosing Caries for Removal
A dentist first identifies a carie requiring removal through a careful examination. This process begins with a visual inspection, looking for changes in tooth color like white or dark spots that indicate decay. The dentist will also look for visible pits or holes on the tooth’s surface. A tactile examination follows, using a dental explorer to check for softened areas, which is a sign of decay.
To see decay that is not visible, such as between teeth or under an existing filling, dental X-rays are used. These radiographs provide a clear image of the tooth’s internal structure, revealing the extent of the carious lesion. This information helps the dentist determine the severity of the decay and if removal is the appropriate action.
The Conventional Removal Procedure
The most common method for caries removal begins with a local anesthetic to numb the tooth and surrounding gum tissue, preventing pain. Once the area is numb, the dentist isolates the tooth using a rubber dam or cotton rolls. This keeps the tooth dry from saliva, which allows for a cleaner working area and better adhesion of the filling material.
With the tooth isolated, the removal of the decayed structure begins. A dental handpiece, known as a drill, is used to remove the soft, decayed portions of the tooth. The dentist uses different types of burs—small rotating instruments—to cut through the enamel and dentin until all compromised tissue is gone.
After the decay is removed, the space is prepared for the filling. This involves shaping the cavity to ensure the restorative material will be secure and supported. The dentist cleans the area before placing the filling, such as tooth-colored composite resin or dental amalgam, to restore the tooth’s original shape.
The final stage is finishing the restoration. If a composite resin is used, a special curing light hardens the material. The dentist will then shape and polish it to match the tooth’s contours and check the patient’s bite, making adjustments for a smooth and functional surface.
Modern and Alternative Removal Techniques
Beyond the conventional drill, modern techniques offer less invasive ways to manage dental caries. One method is air abrasion, which works like a small sandblaster. This technique uses a fine stream of particles, such as aluminum oxide, propelled by compressed air to wear away decayed tooth structure. Air abrasion is well-suited for small cavities and may be used without anesthesia.
Laser dentistry utilizes a high-energy light beam to remove decayed tissue. The laser can precisely target and vaporize decay while leaving healthy tooth structure intact. This method is quieter and produces less vibration than a drill, which can reduce patient anxiety and minimize bleeding.
A different approach is the application of Silver Diamine Fluoride (SDF), which stops decay rather than removing it. SDF is a liquid painted onto a cavity; its silver component kills bacteria while the fluoride helps harden the tooth. This treatment arrests the cavity’s progression but permanently stains the treated lesion black.
Recovery and Aftercare
Following a caries removal procedure, the local anesthetic will wear off over a few hours. While numbness persists, it is advisable to avoid chewing on the treated side to prevent accidentally biting your cheek, tongue, or lips.
In the days after the filling is placed, you might notice temporary sensitivity in the treated tooth. This sensitivity can be triggered by hot or cold temperatures, sweet foods, or pressure from biting and subsides within a few days to a week. Using a desensitizing toothpaste can help manage this discomfort.
Maintaining good oral hygiene protects your new restoration and prevents future decay. You should continue to brush twice a day and floss daily, paying gentle attention to the area around the new filling. A consistent cleaning routine and a diet low in sugar will help ensure the longevity of the treatment.