Figure 5-5.Arrested caries.
DISEASES OF THE DENTAL PULP
Recurrent caries are decay processes that occur
underneath existing dental restorations. More simply
stated, another cavity has occurred in the tooth where
there was a filling or restoration. Some of the causes
are as follows:
Improper cavity preparationThe dentist was
unable to remove all of the decay in the tooth
before the placement of a restoration.
Inadequate cavity restorationOpen margins
(space in-between the restoration and tooth).
Old restorationsThe margins of the
restoration break down or are not completely
sealed when originally placed, creating a "leaky
TYPES OF CARIOUS LESIONS
Depending on its location, a carious lesion is
designated as either a pit and fissure type or a smooth
Pit and fissure caries develop in
depressions of teeth surfaces that are hard to keep clean
of food debris and plaque.
Smooth surface caries usually develop on the
proximal surface (fig. 5-6) or the gingival third of
facial and lingual surfaces on the teeth. These areas
(interproximal) the teeth are where plaque
and form, starting the decay process.
The dental pulp is a living tissue. All living tissues
can die or become diseased. The dental pulp is
composed of vascular connective tissue encased in
dentin, which provides protection. Even with this
protection, the pulp may receive injuries by thermal
changes, carious lesions from micro-organisms, and
mechanical trauma. The extent of pulpal damage and
the vitality (life) of the tooth depend on the severity of
injury and how the pulp will react to disease. The term
pulposis refers to any disease involving the dental
pulp. Some of the more common diseases of the pulp
are pulpalgia, pulpitis, periapical abscess, and
necrosis, which are briefly explained next.
Pulpalgia refers to pain in the dental pulp, and
commonly occurs after a restoration has been placed in
a tooth. It can also be caused by root planing and
periodontal surgery. The tooth may become sensitive
to touch, temperature changes, and sweet or sour
foods. Pain associated with pulpalgia has been
described as short, sharp shooting pain that may
increase when lying down or walking upstairs.
Pulpitis is an inflammation of the dental pulp,
usually caused by a bacterial infection resulting from