Tooth decay primarily occurs when plaque, a sticky film of bacteria, builds up on teeth and produces acids that erode enamel. If left untreated, it can penetrate deeper into the tooth and reach the nerve, leading to various complications.
Although most people think of tooth decay as something that can be avoided for a long period of time, it is highly recommended to treat the condition as soon as possible to avoid further complications. Once tooth decay progresses through the layers, it affects the innermost nerve, also known as the dental pulp. This eventually leads to severe pain, infections, and even tooth loss. That is why it is important to understand how tooth decay affects the nerve in order to prevent long-term dental problems and maintain overall oral health.
The anatomy of a tooth
To properly understand how tooth decay affects the nerve, one must first understand the basic structure of the tooth. A tooth is made up of several layers, which are as follows:
1. Enamel: Enamel is the outermost layer of the tooth, it is a hard and resistant substance that protects it from external damage. It is the most mineralized and durable substance in the entire human body.
2. Dentin: Beneath the enamel is dentin, a soft, porous layer that is more susceptible to cavities.
3. Pulp: The innermost part of the tooth contains the dental pulp, which is a soft tissue made up of nerves, blood vessels and connective tissue. It is also called tooth pulp.
“nerve center”.
Tooth decay primarily occurs when plaque, a sticky film of bacteria, builds up on teeth and produces acids that erode enamel. If left untreated, it can penetrate deeper into the tooth and reach the nerve, leading to various complications.
The stages of tooth decay and how it affects the nerve
1. Early caries (enamel erosion): During the early stages, tooth decay is mostly limited to the enamel. During this stage, you may not feel any discomfort at all, as the enamel does not contain nerves. However, small cavities begin to form as bacteria break down the minerals in the enamel.
2. Progression to Dentin: Once the decay breaks through the enamel, it reaches the dentin. Unlike enamel, dentin is porous and contains microscopic tubules that connect directly to the nerve of the pulp. As the bacteria penetrate the dentin, one may start to feel an increased sensitivity to hot, cold, and sweet foods. Therefore, at this stage, the decay can still be controlled with a filling, but if left untreated, it progresses to the other layers.
3. Pulp Invasion: If the decay continues to spread without treatment, it will eventually reach the dental pulp. When bacteria invade the inner chamber, inflammation occurs, which is a condition called pulpitis. This puts pressure on the nerve and causes severe pain that may come and go continuously. Therefore, at this stage, the pain becomes unbearable and requires proper medical treatment.
4. Pulp Infection (Abscess Formation) – Once bacteria reach the nerve, the risk of infection increases. Bacteria have the ability to grow within the pulp chamber, leading to the formation of an abscess, which is a pocket of pus at the root of the tooth. The infection can spread to the surrounding tissues, including the bone, and results in swelling, severe pain, fever, and difficulty chewing. Therefore, at this point, the nerve within the tooth is irreparably damaged and requires root canal treatment or, in severe cases, tooth extraction.
5. Necrosis (nerve death): If the infection is left untreated, the nerve within the pulp is likely to die. While this may initially relieve pain, as the nerve can no longer send pain signals, the surrounding tissue is still at risk. Dead tissue provides a breeding ground for bacteria, leading to further infection, bone loss, and eventually tooth loss. This condition is known as necrotic pulp and requires immediate intervention.
Signs that tooth decay has reached the nerve
One might wonder how to determine if tooth decay has reached the nerve. To shed light on this, India.com spoke to Dr. Nisha Sancheti, celebrity dentist and founder of Dr. Nisha Dental Care Clinic in Worli, who explained that this usually happens through the following symptoms:
1- Persistent toothache: This is the first sign that tooth decay has reached the nerve, as the pain varies from a mild discomfort to an intense, stabbing pain that radiates through the jaw and face.
2- Increased sensitivity: Our teeth are very sensitive to temperature changes and certain foods, especially sweets. Therefore, this sensitivity persists after the stimulus has been removed.
3- Swelling and redness- The surrounding gum tissue is likely to become swollen, red, and tender to the touch due to the pulp infection.
4- Abscess formation: A visible abscess or pus-filled swelling forms around the root of the teeth or in the surrounding gum tissue.
5- Bad taste or smell: A bad taste in the mouth or bad breath in the mouth are probably caused by an abscess in the presence of an infection.
Treatment options for tooth decay affecting the nerve
Timely treatment is essential to save the tooth and avoid further complications once the decay reaches the nerves. Some of the most common treatment options are:
1- Root canal treatment: This is the primary and most recommended treatment option for cavities once they reach the nerves. During a root canal, the dentist removes the infected pulp, cleans the root canals, and seals them to prevent future infections. This process allows patients to keep their natural tooth while eliminating pain and infection.
2- Tooth extraction: In cases where the damage is too extensive, tooth extraction is necessary as it is the last resort if the infection becomes uncontrollable or the tooth structure becomes too weak to save. After extraction, several options such as dental implants or bridges can be used to replace the missing tooth.
3- Antibiotics: If the infection extends beyond the tooth and into the surrounding tissues, antibiotics are prescribed to control the infection. This is usually done in conjunction with a root canal treatment or extraction.
How to prevent tooth decay from reaching the nerve
Fortunately, it is possible to reverse tooth decay during its early stages of demineralization. During these stages, it is advisable to maintain good oral hygiene to help rebuild the minerals in the tooth. Some tips to reverse the progression of a cavity in the early stages are:
- Keep your sugar intake under control: Try to limit foods that are high in sugar or starch.
- Brush your teeth twice a day: Brushing your teeth frequently can help prevent dental problems.
- Floss daily: Flossing at least once a day can help clean between your teeth.
- Use a suitable mouthwash: Try using a fluoride mouthwash in your nightly brushing routine.
- Regular dental checkups: Visiting the dentist regularly helps to perform a deep cleaning at least every 6 months.
Unfortunately, once a cavity has formed a hole in the tooth, it is no longer possible to reverse the damage and treatment will be necessary.
Conclusion
Tooth decay may seem like a minor problem at first, but if left untreated, it can have serious consequences, including damage to the nerve of the tooth. When decay reaches the nerve, it causes pain, infections, and can ultimately lead to tooth loss if not treated properly. Understanding the progression of tooth decay and taking preventative measures can help protect your teeth from reaching this critical stage. Regular visits to the dentist and maintaining good oral hygiene are essential steps to preserving both your teeth and your overall health.
