No Pain Doesn’t Always Mean No Problem: A Modern Approach to Tooth Decay
Many people assume that if a tooth isn't hurting, it must be healthy. Unfortunately, tooth decay can progress quietly for a long time before it causes any discomfort.
Why decay often doesn't hurt
Early decay begins in the enamel, the tooth's outer layer, which has no nerves.
As decay spreads into the softer dentine beneath, sensitivity may be mild or absent.
Pain often only appears once decay is deep and close to the nerve. By then, treatment is usually more involved.
That is why regular examinations, and X-rays where appropriate, are so valuable. They allow us to find decay long before you would notice it.
A proactive, minimally invasive approach
In the UK, a modern philosophy known as Minimum Intervention Oral Care has been championed by Professor Avijit Banerjee of King's College London. Rather than simply "drilling and filling", it focuses on four linked steps:
Identify: assessing your personal risk and detecting decay early
Prevent: tailored advice on diet, fluoride and cleaning to stop decay progressing
Restore: when treatment is needed, removing only what is necessary and preserving healthy tooth
Review: recall visits tailored to your individual risk
The benefits of acting early
Early decay can often be stopped without any drilling, using fluoride and changes to your routine.
More natural tooth is preserved, keeping teeth stronger for longer.
Smaller fillings, when needed, which are often quicker and more comfortable to place.
Less risk to the nerve, reducing the likelihood of root canal treatment.
Breaking the repair cycle: every time a filling is replaced, a little more tooth is lost. Starting small helps teeth last a lifetime.
How we can help
At every examination, we look beyond pain to your overall risk, so we can act early and treat gently.
Book your examination with Whitland Dental Co on 01994 238 660 or at www.whitlanddental.co.
References
Banerjee, A. (2013). Minimal intervention dentistry: Part 7. Minimally invasive operative caries management: Rationale and techniques. British Dental Journal, 214(3), 107–111. https://doi.org/10.1038/sj.bdj.2013.106
Banerjee, A., Frencken, J. E., Schwendicke, F., & Innes, N. P. T. (2017). Contemporary operative caries management: Consensus recommendations on minimally invasive caries removal. British Dental Journal, 223(3), 215–222. https://doi.org/10.1038/sj.bdj.2017.672
Office for Health Improvement and Disparities. (2021). Delivering better oral health: An evidence-based toolkit for prevention (4th ed.). https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention
Pitts, N. B., Zero, D. T., Marsh, P. D., Ekstrand, K., Weintraub, J. A., Ramos-Gomez, F., Tagami, J., Twetman, S., Tsakos, G., & Ismail, A. (2017). Dental caries. Nature Reviews Disease Primers, 3, 17030. https://doi.org/10.1038/nrdp.2017.30
Schwendicke, F., Frencken, J. E., Bjørndal, L., Maltz, M., Manton, D. J., Ricketts, D., Van Landuyt, K., Banerjee, A., Campus, G., Doméjean, S., Fontana, M., Leal, S., Lo, E., Machiulskiene, V., Schulte, A., Splieth, C., Zandona, A. F., & Innes, N. P. T. (2016). Managing carious lesions: Consensus recommendations on carious tissue removal. Advances in Dental Research, 28(2), 58–67. https://doi.org/10.1177/0022034516639271
