Progressive form of caries

If a deep caries is not healed early, the so-called penetrating caries (caries penetrans) develops. The infestation extends through the dentin to the pulp cavity (pulp cavity), the pulp is thus in direct contact with the caries-causing bacteria. These bacteria lead to inflammation, damage the pulp and the nerve fibres within it and cause severe, stabbing toothache.

If the dentist wants to heal these caries, he can no longer do so with a dental filling including underfilling. In this case, the pulp and nerve fibers must be removed. The nerve fibres run inside the root of the tooth in a canal (root canal) that reaches into the jawbone.

To prevent the inflammatory processes from spreading to the jawbone, this canal must also be freed of nerve fibers and disinfected. Usually, an antibacterial medication is left in the tooth for a few days. This treatment is called root canal preparation (short: WK).

Afterwards, the dentist fills the root canal with a material that is compatible with the body and places both a “normal” tooth filling (root canal filling WF). Root canal treatment is considered the most important way to preserve the affected tooth in cases of very deep caries defects. In the case of very extensive caries defects, it may also be necessary to make a dental crown.

Can a hole heal again?

A hole in the tooth is usually preceded by caries. Of course, caries can be inactivated as described above. This would stop the caries and the hole would at least not expand due to the bacteria.

Such a small hole is often found in a fissure in the molar tooth. Although the dentist gets a little stuck there with the pointed probe, the superficial lesion does not grow any further over time. Therefore, there is no risk of caries and no urgent need for treatment.

However, the tooth destroyed by caries is a problem in that the carious tooth substance is less solid and therefore less stable. If the chewing forces are greater, the tooth surface may collapse or a piece of the tooth may break off. However, a hole that has already been created in the tooth surface will never go away by itself, as the body is not able to produce new enamel. It can and should only be filled again by the dentist to prevent greater damage and to ensure the chewing function of a tooth.