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Advanced stages of the carious process


Following up from last week’s article about causes and symptoms of dental caries, I have decided to address the latter stages of the carious process, which is what most commonly brings the patient into the dental clinic in pain. Last week, I mentioned that a caries in the dentine may cause sensitivity to hot and cold stimuli and that the severity of the pain experienced is dependent on the extent of the cavity.{{more}} So, from this, we can extrapolate that when the caries affect the pulp which houses nerves and blood vessels, then this can cause excruciating pain, the type that keeps you up at night and forces you to finally do what you have constantly been putting off, and that’s seeing the dentist. At this point, the tooth can be painful, but if the process is slow, it can also be symptomless as it advances to what we call a non-vital tooth, accompanied most commonly by a large cavitation and discolouration.

At this stage, if the patient does not see a dentist, which allows for the process to continue, then the entire pulp decays and the infection is allowed to escape the root and cause what we know as a dental abscess. This is generally very painful, especially on chewing. This, most times, is unbearable and forces the patient to seek care. However, if this process is further ignored, then the patient can develop a swollen jaw or even what is called facial cellulitis, from the proliferation and spreading of this infection.

It is not common with modern day medical advancement and availability of medications, but if allowed for some reason to go on without treatment, then this infection can further spread to the brain, heart or other vital organs and cause death. This is why as dentists, we advise that you visit at least twice a year and take all treatment seriously.


A tooth that is affected by caries, but where the pulp is not affected, can be adequately treated by a filling. However, as it advances into the pulp, a root canal is necessary, as the tooth must now be rid of the infection and the pulp replaced. After the root canal is completed, because the pulp has been eliminated, the tooth is now dead and becomes brittle, creating the need for a dental crown to reinforce the tooth. These procedures are more costly, so it’s worthy to point out that your delinquency can be costly.

Have a great week.

Dr Keith John

Email:[email protected]

Clinic: SVG Dental Corporation

Telephone: 784-456-2220

Cell: 784-526-0752