Cavities between teeth erupt like a secret, inconspicuous evil which slowly destroys your oral health. Therefore, prompt conservative treatment is of the essence. Before we jump to the various conservative treatment approaches to treat cavities between teeth, it is essential we first discuss a little about conservative dentistry and what it entails. So, without any further adieu, let’s get started.
What is Conservative Dentistry?
Conservative dentistry is a subspecialty of dentistry which aims to provide dental treatments as conservatively and with minimal invasiveness as possible. Conservative dentistry is often called restorative dentistry as it also focuses on restoring damaged teeth, thus, restoring a tooth’s form and function.
Conservative dentistry removes minimal tooth structure to repair decayed and damaged teeth. This process of minimal removal and conservation is desirable for the doctor as well as for the patient. Dental science has advanced, and a plethora of restorative materials have been introduced in recent times. However, even now, the natural enamel and dentine of the teeth are still the best dental materials in existence.
Therefore, it is desirable to save the natural structure as much as possible while also removing the decayed and damaged parts. Enamel, once formed, cannot be formed again; therefore, once a tooth is decayed or damaged, it becomes essential to remove the infected material and replace the removed tooth portion with a suitable dental restorative material.
Conservative dentistry is minimally invasive, which contributes to greater patient comfort, lowers the need for local anaesthesia and makes the prospect of saving the tooth in question for a lifetime a real and substantial possibility.
Fortunately, newer techniques and advances have made it possible for dentists to be genuinely conservative with their approach. Newer adhesive materials and in-depth examinations further reduce the need to be aggressive with treatment. Conservative dentistry has been desirable and now is a real possibility.
In further sections, we will discuss conservative dentistry treatment with regard to cavities between teeth.
How Do Cavities Develop Between Teeth?
Dental professionals call cavities that form between teeth Interproximal caries (cavities). Interproximal cavities form the same way as any other type of cavities. There are small gaps present between teeth.
While these can be large in some people, in most, this gap is tiny. Food debris can easily get stuck in these areas, and plaque formation can begin. These little gaps are also extremely difficult to clean as a regular brush cannot reach here. Thus, flossing is vital for maintaining optimum oral health.
However, in the absence of proper oral hygiene, plaque accumulates in these areas, and the bacteria residing in them get to work. The bacteria metabolise the sugars from the food we eat to release toxic by-products. These by-products are acidic in nature and slowly start dissolving from the areas between two teeth.
If the destruction is left untreated, it slowly progresses to form holes in the sides of both teeth and leads to the formation of interproximal cavities. The infection will slowly progress to involve the deeper layers of the tooth, which then requires more invasive treatment like root canal therapy.
In some cases, the bacteria may even enter the bone and infect it, leading to the formation of a pus-filled cavity (abscess). In such a situation, the only option is tooth extraction.
Fortunately, complications such as these can be easily avoided by getting cavities between teeth treated at the earliest with the help of conservative dentistry. Therefore, regular dental visits are essential since cavities between teeth do not become apparent until they are big enough.
Signs and Symptoms of Cavities Between Teeth
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Slight discolouration between two infected teeth (starts white, turns brownish, then blackish-brown)
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Pain in two adjacent teeth
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Pain on biting down or while eating
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Pain ranging from dull-aching to severe and throbbing, depending on cavity depth
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Food getting stuck between the affected teeth
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Sensitivity to hot and cold
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Gum inflammation around affected teeth
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In advanced cases, pus discharge may be visible
How Are Cavities Between Teeth Diagnosed?
Firstly, I, Dr. Viorel Talpa, will conduct a thorough oral examination to spot signs of dental cavities. As conservative dentists, we are trained to notice the earliest signs of dental cavities.
However, the best way to ensure proper diagnosis and determine the extent of dental cavities is to take intraoral X-rays. X-rays help determine the size and location of your cavities and aid in proper conservative treatment.
How Are Cavities Between Teeth Treated?
Conservative dentistry believes in saving as much of the healthy tooth structure as possible; therefore, treatments are carefully curated for each individual based on the extent of the cavity.
Fluoride Treatment
If cavities between your teeth are diagnosed early, they can be remineralised with fluoride. This means you will not need any invasive treatment.
After cleaning the teeth, I will apply a fluoride gel or varnish to the infected teeth’ surface. With repeated treatments and dietary modifications, the enamel will remineralise, and the tooth will be saved.
Fluoride treatments also strengthen teeth and make them resistant to future cavities. However, fluoride treatment only works for cavities that are spotted very early (white patch stage).
Dental Composite Fillings
Gone are the days when healthy tooth structures had to be sacrificed for silver amalgam fillings. Silver amalgam cannot bond to the tooth and requires special tooth preparation.
Now, with dental composite resins, we can treat cavities without removing healthy tooth structure. Dental composites chemically and mechanically bond to the tooth.
A phosphoric acid etchant is applied to open up the tooth surface, allowing the composite to adhere. The tooth-coloured composite resin is applied in layers, hardened with UV light, and then polished to match your natural tooth.
Conservative treatments like these preserve tooth strength, enhance aesthetics, and ensure long-term oral health.
Inlays and Onlays
If the cavity is large and cannot be filled directly, inlays and onlays are suggested. These are indirect restorations made outside the mouth and fixed with dental cement.
I will clean the tooth, take an impression, and use it to create a custom-fit inlay or onlay made of porcelain or acrylic, matching your natural teeth shade.
Pulp Capping
When the cavity reaches near the pulp, pulp capping is performed. A layer of calcium hydroxide is placed to stimulate secondary dentine formation and seal the defect. The rest of the area is restored with composite resin.
Root Canal Filling
In advanced cases where decay reaches the dental pulp, a root canal treatment is necessary.
I will first anesthetise the tooth, then open it using a dental drill to access the root canal. Infected pulp material is removed, and the canal is cleaned and filled with root canal filling material.
Finally, the tooth is sealed with composite resin, and if needed, a dental crown is placed for extra protection.
Final Thoughts
As a conservative dentist, I will always aim to use the least invasive procedure possible to treat cavities between teeth. You can rest assured your teeth will remain safe and protected.If you have any questions or wish to schedule an appointment, please reach out to us. I, Dr. Viorel Talpa, and my team of excellent dental professionals are here to assist you.
