Tooth decay

“I have a cavity and need a deep gum cleaning? But Doc, my teeth don’t hurt, why do you want to drill them?”. This is a common daily conversation in many dental offices.

Dental x-rays and clinical exams might reveal the presence of decay in your tooth, or gum inflammation, regardless of pain. In medicine and dentistry, pain is one way problems are diagnosed. Most of the serious disease like high blood pressure, diabetes and even cancer are painless.

If your dentist informs you that you have a problem but you have no symptoms, the lack of pain could be due to many reasons. Let me explain why. When tooth decay is still within the enamel layer (the outer layer of the tooth), where there is no nerve, or the decay and infection has taken a chronic painless pathway. It’s more often than not, we see infection from decay to the nerve and around the tooth, but the patient has no pain, or just a dull periodic discomfort.

It’s also possible that the decay could be in a tooth that had a root canal done previously, hence there is no nerve and, no sensation, yet the tooth structure is being weakened by the decay. Moreover, advanced gum and bone inflammation (periodontitis) is totally painless. Patient might notice redness and bleeding gums, while the teeth are being stripped off the supporting bone slowly, and painlessly. It’s often called “the silent killer of teeth”.

Periodic checkup and exam is very important, because it help diagnosing the problems at an earlier stage. The treatment (if needed) will be simple, not as costly, with a lot less time and complications.