The tooth is coated with Enamel, which is harder than diamond. Below is Dentine another layer within which is the pulp, which continues into the roots, containing nerves supplying the tooth which give pain.
BRUSHING HARD abrades the Enamel and encourages cavities. The natural mechanism of cleaning the teeth is chewing. Our diet lacks raw food (salad and fruit) and is full of acidic food (processed and preserved), altering the PH of the oral cavity and encouraging disease and infection.
A CAVITY appears essentially because of a faulty diet, which changes the PH of the oral cavity, rendering it more acidic and susceptible to infection. Bacteria invade the tooth and make it porous, drilling the enamel and if deeper the dentine. The process of cavity reaching the dentine or pulp may take years. The exposed dentine causes pain which prevents the patient from eating faulty food, allowing the oral PH to recover. In a few weeks the dentine may generate a blackish coating which protects tooth from further bacterial penetration and relieves the pain.
Your Dentist will drill the existing cavity, grazing the tooth further to remove the infection and fill it up with a silver filling or COMPOSITE FILLING. While this will relieve the pain immediately, any residual bacteria will find no outlet and in a matter of a few years, invade deeper into the dentine to penetrate the more sensitive pulp. Now the Dentist will have to drill even deeper to remove infected layers of the tooth and in turn, weakening the tooth. Now the tooth will require a CROWN (METAL OR CERAMIC CAP). The other natural healing alternative may be to leave the cavity open, as it is, allowing the cavity to drain easily to the outside. Sometimes a softer filling like Glass Ionomer material, is better, as it is softer and less adhesive in nature, enabling it to come out easily if infection develops under the filling.
The metal cap may further trap infection within or may allow food stagnation at its edges encouraging infection to penetrate to ONE of the deeper nerve roots. Now the pain is intensely unbearable and the dentist will suggest ROOT CANAL TREATMENT, which is essentially surgically destroying ALL of the 2-3 roots with wires to render the nerves dead and incapable of causing pain. Now the nerveless tooth becomes fragile and needs a cap. The cap may block the space between adjacent teeth and once again cause stagnation, paving the process for infection of the nearby teeth.
Alternatively when the infection reaches the root, it will destroy one root and may leave the other roots intact. Dentists may argue that it may destroy the other roots in course of time. In any case, the cavity if left open without a filling will encourage regular cleansing of the roots during gargling and brushing. So if the root of affected tooth is left as it is, it will still serve as a living root, with oral sensitivity, function and capable of good chew-ability from the unaffected part. The Dentist may also consider filling the affected root only, which is quite a radical viewpoint.
In older age groups, cavities are less frequent while infection of the gum and ligaments holding the tooth, more common. This is called PERIODONTITIS and causes severe pain on chewing. The Dentist shall prescribe antibiotics and pain killers. However, avoiding antibiotics may help the body to sort out its immune defences and give permanent immunity against the offending bacteria. Many a time, without medication, this pain vanishes on resting the tooth by preventing chewing on that side.
At other times, severe infection may not resolve and cause abscess formation and intense pain. The traditional resort is to do root canal treatment and drain the infection. So the tooth is killed to heal the gum. If untreated, the gum infection will result in a pus pocket which opens in the gum and drains out into the oral cavity, healing the tooth. Some dentists at this stage will advocate removal of the tooth. However, simply bearing the pain of periodontitis for about a week, may result in its spontaneous resolution by drainage of pus.
With ageing and bone loss, one of the roots may loosen, causing the tooth to shake in its socket. Part of the tooth may crack and break off. The dentist may advice extraction of the tooth, which may be rigidly held to the underlying bones.
The option is not to extract the tooth, but preserve the roots. Extraction of the whole tooth with the roots will cause an empty space and thereby loosen the nearby roots of the adjacent teeth.
A Denture is prescribed to occupy the extracted or fallen tooth. The Denture requires removal of the entire tooth along with its roots, to make a socket to hold the denture.
However the denture may be unnecessary when the roots are preserved, as the gums close over it, allowing the patient to chew without a denture. In bedridden patients, the denture may fall off and block the windpipe and cause death by choking.
Removal of wisdom teeth is also unnecessary as they have the wisdom to pave their way and erupt despite the gums blocking it. Also Smile correction surgery may involve extraction of four canines to align the mal-aligned teeth. It’s not worthwhile to smile after losing 4 teeth and lose a part of your chewing ability. Many times, the front teeth or incisors are capped to augment and enhance the smile. Capped incisors are incapable of chewing hard food and now the patient has to bite the apple with his molars (back teeth) and then pass the bits to the front teeth for mastication! The exact reverse of the normal chewing process. So much for a smile!
In summary, tolerance of pain, belief in the oral wisdom, healthy eating habits, oral hygiene (by gargling and gum massage) and avoiding antibiotics may give better life to your teeth than interventional and urgent dental attention.