Dental diseases.

Caries, pulpitis and periodontitis are the most common dental diseases. Various dental diseases affect different tissues of the tooth and progress in certain locations. Caries usually affects the crown of the tooth and destroys its hard tissues. This process is rather easy to spot. Such diseases as pulpitis and pulp necrosis are contained within the tooth itself and without timely treatment lead to periodontitis and/or root tooth root resorption. Periodontitis is not limited to the tissues of the tooth; it involves the tissues that surround and support the tooth and often spreads into the surrounding bone. Caries is the most common tooth disease, which is also called tooth decay or cavity.

Caries is acid erosion of the hard tissues of the tooth, such as enamel and dentin. Caries can be easily diagnosed even by a lay person, if it is located in an easily visible part of the tooth. Caries of interproximal surfaces is located at the point of contact between teeth and is much more difficult to detect. Caries under fillings is also rather difficult to diagnose. There are several symptoms that may imply the presence of caries:

• Visually detectable cavity on the surface of the tooth or a spot that is noted by passing a sharp instrument or where such an instrument would “sink in”.
• Local change of colour on the tooth surface from matt white to dark brown or even black.
• Tooth pain to cold, sweet or acid stimuli that disappear as soon as the stimulus is no longer present.

Pulpitis or the inflammation of the nerve, as it is called by laypeople, is a complication of dental caries. As the carious cavity deepens and affects deeper structures of the tooth, oral cavity infection spreads into the pulp. The inflammation caused by this infection is called pulpitis. There are several symptoms of pulpitis that should help the patients themselves to suspect this disease. They are as follows:

• Big unclean cavity in the tooth that is acutely painful when touched with a sharp object and especially when pain is concentrated in one particular point (“exposed nerve”).
• Spontaneous prolonged medium or intense pain, especially when the patient is at a state of rest.
• Very high level of tooth sensitivity to cold or hot.

Periodontitis is a disease that causes inflammation of the periodontal ligament. It is not a dental disease per se because the teeth surrounding periodontal ligament is not part of the teeth. The most common cause of periodontitis is a long untreated inflammation of the dental pulp. Since in almost all cases of periodontitis the tooth is dead, people often ask why the disease that affects a dead tooth is accompanied by pain. In reality the pain originates not in the tooth itself but in the swollen periodontal ligament that surrounds the tooth. For a layperson it is rather tricky to diagnose periodontitis, however, this disease can be suspected if there at least some of the following symptoms:

• Soreness or rapid aggravation of pain without apparent cause or when the tooth is tapped/pressed.
• The sense of a “swollen tooth”.
• Gray discoloration in a tooth whose root canal has never been filled.
• Discharge of pus from the tooth, through the defect of the tooth.
• Swollen gums around the root of the sore tooth; when touching the gums it feels as if there is a pocket filled with liquid.
• Swelling of the soft tissues of the face that is often accompanied by a general sense of feeling ill.