Large dents occur in roads when the hard protective surface thins and breaks to reveal the soft underbelly of its foundation. Teeth sometimes develop potholes too, based on the same principle. And the unveiling of their soft centres can be just as hazardous to our teeth and general health as the potholes on roads are to our cars and, sometimes, to our lives.
Tooth potholes, small round dents in the teeth, result when the tough enamel armour on our teeth thins in patches. This revealing the soft dentin which houses the nerve endings in our teeth exposed and sensitive. This results in a great deal of pain, an increased chance of decay, and possible tooth loss.
What causes potholes?
Potholes in our teeth can be the result of bad habits, bad diet and poor oral hygiene. They can also be caused by using teeth for purposes other than what nature intended. Have you ever opened a bottle by clenching it between your teeth? Or bitten off a loose thread, and perhaps cut fishing nylon or clothing tags with your teeth when the scissors have gone AWOL? Most people have done so. And they have regretted it when their teeth start to hurt, crumble and decay.
Harsh brushing: Using a hard toothbrush and an abrasive toothpaste can damage the enamel. It is far better to brush gently, using a soft brush and a fluoride toothpaste.
Diet: Although enamel is rated to be stronger than almost any other substance, including steel, acidic food and beverages are its Achilles Heel. When too much acid flows over the teeth too often, and pools in the hollows of the molars, the acid can cause demineralisation. This, in turn, weakens and thins the enamel.
Grinding your teeth: We all know it’s a bad habit. But like most habits, it is hard to stop. Particularly as clenching and grinding teeth often happens when we are asleep. It is, however, a major cause of damage to our tooth enamel.
Chalky teeth: Dental cavities in children may not necessarily be the result of poor diet or bad dental hygiene. Many can result from Development Dental Defect (D3), a mineral absorption problem that can affect as many as 1 in 6 children. D3 causes a deficiency in calcium (molar hypomineralisation or molar hypomin). This weakens the enamel, leaving the exposed parts porous and soft and far more vulnerable to decay. The worst affected are the molars which are considered to be the first of the adult teeth, particularly the so-called six-year-old ones.
Why does it happen? Indications are that it could be the result of sickness in infancy, but which sicknesses cause it, still remains unclear. If detected early enough, chalky teeth can often be treated. However, if not detected, the damage caused to the enamel can result in decay, potholes and pain. If the damage has gone far enough, it might even be necessary to remove the tooth.
Treatment for potholes
Depending on the severity of the decay, the dentist will have several options for treating potholes.
- Dental sealants are the first line of defence. These composites, usually involving a base of resin or glass ionomer cement, can provide protection for about 5 to 10 years. This is provided they are checked at regular intervals, to make sure the sealant hasn’t pulled loose from the tooth.
- Fluoride treatment: A fluoride varnish is an alternative to sealants. It can be painted onto decay-free teeth when the enamel has thinned, to form a protective layer to prevent cavities.
- Gum guards are custom-made to fit your teeth. If worn regularly at night, they can help prevent the destructive habit of teeth grinding, which can weaken the enamel.
- Fillings: The pothole is not actually a cavity. However, your dentist may decide to treat it almost as if it is one. Provided there is no sign of decay, which might get trapped under the filling, this solution may be proactive in preventing decay forming in the tooth enamel’s weak spot.
- Veneers, bonding and crowns: Again, the area must be without any sign of decay. If it is, the dentist can then consider using bonding or veneers to cover and protect the affected teeth. Bonding involves joining a coloured composite material to the tooth which can be moulded and shaped to cover defects in the tooth. A veneer, on the other hand, is a custom-made hard shell of resin or porcelain, which is attached to the front of the tooth. Should the damage have occurred on the cusp, or top of the tooth, a crown might be the answer.
Visit your dentist for regular check-ups. It’s then that problems like potholes are identified early and treatment is easier and more effective. However, if you notice the development of these round indentations on your teeth, or any other abnormality in your mouth or teeth, don’t wait for your next regular visit. Set up an appointment to see your dentist as soon as possible.