“Does it hurt?” or How do dentists tell if a tooth has a decay cavity?

multiple decayed teeth in the mouth of a senior dental patient of Dr. Adel Zakhary
One of our senior patients before getting their teeth repaired. How many teeth do you think require fillings?

Most people tend think their teeth are perfect, but once they do decide to visit their dentist, their resolve is shaken. How can your dentist tell if the tooth has a cavity or that you have tooth decay? The dentist examines their teeth and at once they begin to tell that something is wrong if the whole examination took a little while longer to the normal checkup, or if the dentist starts to bring in things off the table, and starts to ask the familiar question: “Does it hurt?”. Many times in our clinic, I have seen reactions from our patients ranging from a stunned gaze all the way to “no, Doc, you are wrong, my teeth are perfect”, and the final result is usually baffling.

Telltale signs of tooth decay (dental caries)

what if you as a person could look at your own teeth. Can you see any of these features?

  • chipping (little cracks running on the tooth)
  • mamelons (the little knobs that most people have at the edges of their front teeth)
  • white lines or dark lines on the back teeth
  • broken front tooth
  • yellow white spots under the surface
  • yellow brown pits on the surface (like freckles)
  • dark tops on the back teeth
  • hollow teeth

What about feel?

what if you could feel any of these, along with the signs

  • bad breath
  • pain on chewing, or hot drinks, or cold drinks, or just by closing on teeth
  • tongue touching a jagged or a pointy edge
  • food getting stuck between teeth unlike before
  • looseness of teeth 
  • bleeding from the gum especially when brushing
  • pain in the top teeth with bowing down
  • pain on a flight from teeth
  • tooth chipping away with food

If you experience any of these, then at least one tooth requires care.

What is that poker thing you used?

The outer shell layer of the tooth protects your teeth, what we call – Enamel. The hook (pictured below) detects shell compromisation, and because enamel is strong, that hook (we call it the dental probe) moves across the surface of the tooth and checks between the teeth, since we cant look in between two teeth, in a closed mouth, to probe for cavities, and if the cavities exist (and often times, we are equally surprised they do, along with our patients), we have what we call a catch. This means a compromised tooth and the enamel breaching where the catch is, and that means we need to also take an x-ray. 

dental probe image taken by Dr Adel Zakhary showing the instrument against a black background.
dental probe (hook)

Must you always use the probe when looking for tooth decay?

No. There are other advanced means to tell. We have cavity detector dyes, x-rays (below), and your signs and symptoms from earlier. We resort to these, only in cases where the tooth is visibly destroyed, and we need to make sure also, that we are not going to walk in to the root canal, or if indeed, there is one to begin with. 

dental panoramic x-ray of the presented case of Dr Adel Zakhary confirming the majority of teeth requiring fillings
Panoramic x-ray for our senior case, with majority of teeth require care

How can I make sure my teeth do not get painful during Covid-19?

The whole world was shook by the outbreak of Covid-19, especially countries like the UK, USA, and India. Lots of loved ones and friends, as well as professionals were lost due to the pandemic. With the third wave about, tooth decay can force you to leave your home and thus, you can schedule an appointment at your nearest dentist

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