Tooth decay mostly occurs when plaque, a sticky film of bacteria accumulates on the teeth and produces acids that erode the enamel. If left untreated, it can penetrate deeper into the tooth ultimately reaching the nerve and causing several complications.
While most people think that tooth decay is something they can get away with for a long period of time, it is highly advisable to treat the condition as soon as possible to avoid further complications. Once the tooth decay advances through the layers it affects the innermost nerve which is also known as the dental pulp. This eventually leads to severe pain, infections, and even tooth loss. So this is why understanding how tooth decay impacts the nerve is important for preventing long-term dental problems and for maintaining the overall oral health.
The Anatomy of a Tooth
To properly understand how tooth decay affects the nerve, one needs to first understand the basic structure of a tooth. A tooth comprises of several layers which are as follows-
1. Enamel: The enamel is the outermost covering of the tooth which is hard and tough thing that protects the teeth from external damage. It is the most mineralized and durable substance in the whole human body.
2. Dentin: Under the enamel is the dentin which is a soft and porous layer that is more susceptible to decay.
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 the tooth’s
“nerve center”.
Tooth decay mostly occurs when plaque, a sticky film of bacteria accumulates on the teeth and produces acids that erode the enamel. If left untreated, it can penetrate deeper into the tooth ultimately reaching the nerve and causing several complications.
The Stages of Tooth Decay and How It Affects the Nerve
1. Initial Decay (Enamel Erosion): During the early stages, tooth decay is mostly confined to the enamel. During this stage, one might not feel any kind of discomfort as the enamel contains no nerves. However, small pits or cavities begin to form as bacteria break down the enamel’s minerals.
2. Progression to Dentin: Once the decay breaches the enamel, it then reaches the dentin. Unlike enamel, dentin is porous and contains microscopic tubules which directly connect to the nerve in the pulp. As the bacteria penetrate the dentin, one might begin to feel increased sensitivity to hot, cold and sweet foods. So at this stage, the decay is still manageable with a filling but if it is left untreated then it progresses to the other layers.
3. Invasion of the Pulp: If the decay continues to spread unattended then it eventually reaches the dental pulp. When bacteria invade the inner chamber it leads to inflammation which is a condition called pulpitis. This exerts pressure on the nerve and leads to intense pain which may come and go continuously. Therefore, in this stage the pain becomes unbearable and requires proper medical treatment.
4. Infection of the Pulp (Abscess Formation): Once the bacteria reach the nerve, the risk of infection becomes higher. The 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 surrounding tissues, including the bone, and results in swelling, severe pain, fever, and difficulty in chewing. So at this point, the nerve inside the tooth becomes irreparably damaged and requires root canal treatment or in severe cases tooth extraction.
5. Necrosis (Death of the Nerve): If the infection is not treated, the nerve inside the pulp is likely to die. While this may initially relieve the pain, as the nerve is no longer able to send pain signals, the surrounding tissue remains at risk. The dead tissue provides a breeding ground for bacteria, which leads to further infection, bone loss, and eventually, tooth loss. This condition is known as necrotic pulp, and it 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 Dr. Nisha Dental Care Clinic in Worli, who explained that this typically occur through the following symptoms
1- Persistent Toothache- It is the first sign that shows that the tooth decay has reached the nerve as the pain ranges from mild discomfort to sever, throbbing pain which radiates through the jaw and face.
2- Increased Sensitivity- Our teeth are highly sensitive to temperature changes and certain foods, especially sweets. So this sensitivity then lingers 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 infection of the pulp.
4- Abscess Formation- A visible abscess or a pus-filled swelling forms around the root of the teeth or in the surrounding gum tissue.
5- Bad taste or smell- a foul taste in the mouth or bad breath from the mouth are likely to be caused due to an abscess in the presence of an infection.
Treatment Options for Tooth Decay Affecting the Nerve
Prompt treatment is essential to save the tooth and for preventing further complications once the decay reaches the nerves. Some of the most common treatment options are:
1- Root canal therapy- it is the primary and most recommended treatment option for decay once it reaches the nerves. During a root canal, the dentist removes the infected pulp, cleans the root canals and seals them to prevent further infections. This process allows the patients to keep their natural tooth while eliminating the pain and infection.
2- Tooth Extraction- in the cases where the damage is too extensive, the tooth needs to be extracted as it is the last resort if the infection becomes uncontrollable or the tooth structure becomes too weak to be saved. After extraction, several options like dental implants or bridges can be done to replace the missing tooth.
3- Antibiotics- If the infection spreads beyond the tooth and into the surrounding tissues, antibiotics are prescribed to control the infection. This is often done in conjunction with a root canal or extraction.
Preventing Tooth Decay from Reaching the Nerve
Luckily, it is possible to reverse tooth decay during it’s early stages of demineralizar=tion. During these stages, it’s advisable to maintain good oral hygiene to help rebuild the minerals in the tooth. Some tips for reversing the progression of a cavity in the early stages are-
- Keep your sugar intake in check- try to eat limited overly sugary or starchy foods.
- Brush twice a day- Brushing your teeth often can help in preventing dental problems.
- Floss daily- flossing atleast once a day can help clean between teeth.
- Use a proper mouthwash- try using a fluoride mouthwash in your nightly brushing routine.
- Regular dental checkups- Visiting the dentist regularly helps in getting deep cleaning done at least in 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 issue at first, but if left untreated, it can lead to severe consequences, including damage to the tooth nerve. When decay reaches the nerve, it causes pain, infections, and can ultimately result in tooth loss if not properly treated. Understanding the progression of decay and taking preventive measures can help protect your teeth from reaching this critical stage. Regular dental visits and maintaining good oral hygiene are essential steps in preserving both your teeth and overall health.