Where does tooth decay begin?

June 29, 2010

Decay can begin on the top surface of a tooth, beside a tooth, or underneath the gum, mid-root on a tooth. It can most often be seen on X-rays but not always. Decay that starts at the top of a tooth usually has to be probed and explored with a sharp instrument to see if the hole or decay has gone through the enamel into the tooth itself. If it has advanced from the top surface, then sometimes the X-ray will show the decay. Often, decay on a root or in between teeth is obvious on an X-ray. If decay is on the side of the tooth — the outer or inner (tongue) side — then it may not show up on the X-ray as well. There are also times when scaling and root planing can reveal a cavity that would not otherwise be seen on an X-ray or during a routine dental examination.

It is always good policy to see a quality dentist and hygienist who can do bitewing X-rays to check for cavities every year and full-mouth X-rays every three to five years. The X-ray examination is only one part of the picture — the rest is clinical observation, patient reports of sensitivity or pain, and clinical examination by probing and scaling the mouth and evaluating every tooth for surfaces of decay.

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