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What tooth decay may look like: photos

Author: Yashin Svyatoslav Gennadevich | Last update: 2019
≡ Article 11 has comments

Let's see how diverse caries can look, starting from the early stages of its development and ending with severe carious lesions of several teeth at once.

Manifestations of caries are very diverse. Not only does this disease have several different forms, depending on the location on the teeth, the development of caries itself is also divided into several stages at which carious lesions look quite specific.

For example, in the photo below - generalized caries:

Generalized caries example

With generalized caries, a rather rapid and severe destruction of many teeth in the oral cavity occurs at once.

And this photo shows a single tooth decay:

The carious process can affect one single tooth, while all others remain healthy.

As you can see, the difference is quite substantial and clearly demonstrates that caries can look very, very different.

The following shows caries at an early stage of development, when it is a white or chalky spot (this is how the areas of demineralized enamel look):

White spots on the teeth are areas of demineralized enamel

And in this photo - deep caries, which already threatens to develop into pulpitis:

The photograph shows several teeth affected by deep caries, and this condition is not far from pulpitis, when the nerve will have to be removed during treatment.

It is interesting that at the stage of the spot on caries, most people do not pay any attention - think, the tooth has slightly changed color, you never know what happened to it. But in vain, because at this stage caries can still be cured without a drill, filling and violation of the integrity of the tissues of a living tooth. If you miss the moment, then without installing a seal (at best) it is unlikely that you can already do it.

In many cases, caries develops where it is very difficult to notice (hidden caries) Therefore, even if you well know what tooth decay looks like on your teeth, you cannot be completely sure that if it is not visible in the mouth in front of the mirror, it means that it is not at all. In some cases, even a doctor with a special tool may not notice carious damage, and sometimes the disease can be diagnosed only with the help of special methods of dental examination (x-rays, transillumination, luminescent diagnostics, etc.).

For example, the photo below shows an x-ray of a tooth with a hidden carious cavity:

An x-ray shows a hidden carious cavity on the contact surface of the tooth.

Same tooth when zoomed in

If enamel damage occurs on the approximate surface of the tooth, it can be extremely difficult to discern such caries even with a dental mirror.

Nevertheless, knowing how caries usually looks at various stages of its development, a person can detect tooth damage in time and consult a doctor. This often helps to save both teeth and a significant amount of money, so let's get to know the whole variety of carious injuries closer ...

 

Types of caries: a visual demonstration

Caries is a disease that damages the hard tissues of the tooth: enamel and dentin. With an initial enamel lesion, the carious area usually acquires a milky white color and loses its luster. When it comes to dentin, by this time both areas of porous demineralized enamel and locally the dentin itself usually already look brown or even almost black, since they are colored with various substances, including dyes from food.

Thus, the stage of the disease, the nature of its course and the localization of the lesion complete the picture and determine how exactly the caries on the teeth look: color, size of the lesion, depth of the carious cavity, the number of lesion sites, etc.

For example, below in the photo - fissure caries. On the teeth, it appears on the chewing surface in natural depressions called fissures. In some cases, the black lines are so small that the dental probe and the doctor’s gaze do not linger on them, but often the problem is clearly visible to the naked eye:

Very often tooth fissures are affected by caries - natural depressions on its chewing surface.

Fissure caries is dangerous because large areas of affected dentin can be hidden under seemingly minor enamel damage. For a better understanding, watch a video that schematically shows how tooth decay penetrates deep-seated tooth tissues:

 

Interesting information about the structure of the tooth and its caries damage

And this photo shows another example of how teeth affected generalized caries. This is a very dangerous form of the disease, which threatens a person with the loss of a significant part of the teeth, depulpation (removal of nerves) and the installation of crowns:

Generalized caries of deciduous teeth in a child.

In appearance and nature of the course, bottle caries is close to generalized. The main difference between these diseases is the age of the people they affect: bottle caries develops mainly in children from 1 to 3 years old. This is often associated with weakened immunity and somatic diseases of an early age.

Pictures of Bottle Caries:

Bottle Caries

Another example of bottle caries in a child: if you do not start dental treatment on time, then in a short period of time they can be destroyed almost completely.

A Note About Bottle Caries

The causes of bottle caries go far beyond eating milk, especially at bedtime, as some parents think. It is important here: violation of the feeding regimen, non-observance of hygiene rules by parents in relation to milk teeth, factor of systemic diseases of the baby, aggravating the background of carious processes, directly and indirectly affect the already formed and still not fully mineralized enamel lattice, the composition of the baby's saliva is also important. In general, one definition of “a bottle of milk - caries” cannot be limited.

A separate form is recurrent caries that appears on previously cleaned surfaces. It usually develops at the site of poor-quality tooth treatment around the fillings. In the later stages of development, caries-affected tissues frame the filling and are clearly visible to the naked eye.

The photographs show how caries develops under a filling, manifesting itself in places where it fits to the surrounding tissues of the tooth:

Caries can also develop under fillings, as well as in places where they fit into the surrounding tissues of the tooth.

Such darkened seals must be replaced.

Another option for hidden caries is caries under the gum, where it affects the cement of the root of the tooth. For this reason, it is also called root caries or cement caries. It develops faster than caries of open enamel areas, but it is very difficult to see it.

The photo below shows a removed tooth with root caries:

Root caries, often developing imperceptibly under the gum, may ultimately lead to tooth loss or the need to remove it.

If the disease develops in the cervical region of the tooth, that is, in areas close to the gum, then in this case we are talking about cervical caries. Such a pathology also has a characteristic appearance: at the base, the tooth appears to be undermined, sometimes along the entire perimeter, while the upper part of the crown often remains generally untouched.

The photographs below show several examples of cervical caries:

The photo shows an example when the cervical region of the tooth is severely affected by caries.

In general, cervical areas usually have a thin layer of enamel and are quite vulnerable to carious damage.

Proximal caries is very difficult to detect (sometimes it is called simply - interdental caries): it develops on the surface of the tooth in contact with the wall of the adjacent one. Due to the difficulty in fully cleaning the interdental space with a toothbrush, such caries can grind enamel and then dentin imperceptibly for a long time and often lead to the fact that a person seeks help already at the stage of deep carious tooth damage.

An example of proximal (interdental) caries - note that it is practically not visible:

Interdental (approximate) caries often proceeds in a latent form, visually giving out nothing.

But in the case of a strong growth of the carious cavity between the teeth, such caries already looks quite, so to speak, classically:

However, as the carious cavity between the teeth grows, the problem eventually becomes visible to the naked eye.

It is important to take into account that, although in the majority of the above photos with dental caries, the disease is shown at quite late stages of development, when the dentine was affected and stained, this does not mean that caries is certainly brown or black spots and holes in the teeth. The color of the affected areas depends on the stage of development of the disease, and can vary greatly, having shades from snow-white to black, including all kinds of variations of brown, gray and yellow.

 

Different stages of caries, different external manifestations

In the photo - caries at an early stage of development:

At an early stage of its development, caries leads to demineralization of enamel, as a result of which it sometimes becomes dull, whitens and begins to be pigmented by food colors.

This stage of the development of pathology is called the white spot stage: only the initial enamel damage and the formation of pores in it under the influence of aggressive acids from the oral cavity occur here. Enamel loses its luster, acquires a lighter, saturated white color.

Here are some more pictures of caries in the spot stage:

The initial stage of carious lesions of the teeth is also called the stage of a white or chalk spot.

The photo shows a whitish area of ​​demineralized enamel in the cervical area of ​​the tooth.

And then - the appearance of the carious areas after the through hole was formed in the enamel and the dentin started to fail:

And here caries in the cervical region has almost reached dentin ...

The defeat of dentin marks the onset of the stage of secondary caries.

Further on the photo - caries under a microscope:

This interesting image shows how the tooth tissues destroyed by caries look under a microscope.

On a note

Dentin is much more porous and softer than enamel, and easily absorbs various coloring substances from the oral cavity. That is why, after the start of the lesion, it quickly turns dark.

The picture shows the main stages of development of dental caries:

Stages of caries development: from the initial form to pulpitis.

Under the influence of cariogenic factors, dentin is destroyed much more easily than enamel, and therefore the development of medium caries and its transition to deep decay usually occurs quite rapidly.

With deep caries, as the name implies, the deep layers of dentin are affected up to areas near the pulp. If the pulp itself is affected, pulpitis begins with acute pain and the risk of periodontal inflammation.

An example of deep caries in an x-ray is shown below:

In this x-ray, a deep carious cavity is visible on the contact surface of the tooth.

Important!

Deep caries can develop even without visible lesions on the surface of the tooth. On x-rays, it is clearly visible, and therefore a picture is often taken to diagnose it and determine the extent of the lesion.

Depending on the place of manifestation, deep caries looks different. For example, in the photo below - a rather significant tooth lesion with cervical caries:

Another example of decay in the neck of a tooth.

And here are teeth with deep carious cavities on chewing surfaces:

With such a deep caries on chewing surfaces, chipping of a weakened tooth wall can easily occur, not to mention the high risk of pulpitis.

 

X-ray caries: what it looks like and why photograph it

X-ray pictures of carious teeth allow you to get the most complete picture of tissue damage without opening enamel. The principle of radiography here is that a beam of x-rays is passed through the tooth, which are attenuated differently when the tooth tissue passes. Projecting after such a passage on a sensitive sensor (or film), they show areas where tissues are damaged or missing at all - such areas look darker.

For example, in the x-ray below, a carious cavity in the tooth is clearly visible, which could not be detected with a simple visual examination:

X-ray images help the doctor see those carious cavities that are not found during a routine visual examination.

An X-ray is especially useful for detecting recurrence of caries, as well as root caries and proximal caries. For example, here is a photo where you can see how the approximate caries looks in the picture:

Proximal caries in an x-ray

 

What leads abstinence from visits to the doctor

Due to too long postponement of a visit to the dentist, multiple caries may develop, which is unlikely to add appeal to someone:

..If you postpone a visit to the dentist for a long time, then, for example, a child may be left without teeth ahead of time.

Here is another photo that shows the simultaneous deep caries lesion of several teeth at once:

The same applies to adults - the photo shows an example of multiple caries, when almost all teeth have signs of decay.

And here - acute caries on the front teeth of the child:

In the acute form, caries can destroy teeth in a very short period of time ...

Do not forget that initial caries in the spot stage is usually easily amenable to remineralizing therapy by a dentist and can be treated without preparing a tooth with a drill. You can’t say about deep carious lesions, which can not only cause pain from various irritants, but also turn into a serious complication - pulpitis, when emergency care is often required, since it can be unbearable to endure such pains.

Dentist tells

Many people often ask themselves: can a dentist treat a tooth by himself? I authoritatively declare that such cases occur in practice if the dentist does not trust anyone but himself, or does not have enough funds for these procedures, working in a small town or village.

I can say from personal experience that treating caries in oneself is a difficult matter.You can take a chance only if the working field is clearly visible and the cavity does not have a large area. Despite this, some friends of the doctors did not do this: they independently anesthetized themselves, passed the canal with pulp the front tooth and even with an injection, an incision was made with a "flux" to reduce pain. More often this was due to the inability to seek help from colleagues on holidays (or weekends), or the remote location of the nearest dental office. It sounds incredible, but true: such dentists are extremely fearless people!

The picture shows what happens when caries reaches the pulp and leads to its inflammation:

This picture shows the sequence of stages through which a tooth passes when it is damaged by caries, if it is not treated.

The photographs below show how some stages of tooth depulpation (nerve removal) look like:

It looks like a tooth with a deep carious cavity before treatment

When depulping such a tooth, it is necessary to clean and fill all the root canals at once.

The fate of the tooth in many respects depends on the quality of the treatment of the canals, so this stage is very responsible.

The sooner you notice signs of caries and consult a doctor, the more effective and painless the treatment will be. Caries on the chewing and buccal surfaces of the teeth, and on the front teeth and on the vestibular surface, in many cases, you can independently detect it in the early stages.

For example, here are the front teeth with white spots in the photo - the foci of initial caries:

At the stage of initial caries, treatment can be performed without using a drill - remineralizing therapy

And then in the photo - the oral cavity with teeth affected by fissure caries. Visible, though not large, but clearly visible dark lines on the molars. Installation of fillings here can no longer be avoided, but it is quite possible to prevent pulpitis from developing.

The photo shows the preparation of a tooth with fissure caries for treatment: the affected tissue will be excised, after which they will be replaced with filling material.

The onset or possibility of caries in the near future can also be given by tartar. The photo shows an example of such deposits on the inside of the front teeth:

In the presence of dental plaque, it is necessary to consult a dentist to remove them, since under them caries may begin to develop covertly.

In any case, when looking in the mirror, first of all, you need to pay attention to those parts of the teeth that are significantly distinguished by their color from the neighboring ones. Whether it is too white, beige or, especially, brown - the fact that it differs from the color of intact healthy enamel can already be a sign of tooth damage. And this is a good reason to go to the dentist. If, together with such a non-standard coloring, the tooth also worries, even if not constantly, it should be treated as soon as possible.

 

Interesting video: an example of the treatment of deep caries with the preparation of a tooth with a drill

 

Is it possible to treat tooth decay without pain and without a drill? ICON Technology

 

To the record "How caries on your teeth may look: photos" 11 comments
  1. Kuralay:

    Thank you so much for the VERY helpful information! There would be more like you around the world!

    Reply
  2. Anonymous:

    More x-rays with explanations. And the information is very interesting. Many thanks.

    Reply
  3. Natalie:

    Why do doctors say nothing during the examination? .. For example, what should be done and what is not necessary so that tooth decay does not appear.

    Reply
    • Svyatoslav Gennadievich:

      Hello! The fact is that doctors don’t have much time to “talk”. It’s clear that we are talking about the prevention of the disease, but look at the lines that accumulate in hospitals. And someone in the corridor will surely say: “What has he been chatting there for so long - we have been waiting for 2 hours already”.In private dentistry (not all), the doctor has time, since he writes you down to work out for about an hour or more. Therefore, in addition to the main time, the dentist has 10-15 minutes to talk with you about anything. Sometimes the private trader is not able to pay attention, since the patient with acute pain can “wedge” in your main time, and the extra income is much more important than talking (for this private trader).

      Briefly about the main thing: to prevent decay, it is enough to brush your teeth with toothpaste containing fluorides. The percentage of fluoride is best agreed with the dentist. Brushing teeth only after eating (at least 3 times a day), and do not forget about the spaces between the teeth: irrigators or dental floss.

      If you want to talk with the dentist about hygiene and protecting your teeth from caries, then the most not competent and competent in this regard are dental hygienists and periodontists. Good luck to you!

      Reply
      • Valya:

        Svyatoslav, my dentist told me that no, you can’t brush your teeth 3 times a day, "the enamel will be damaged." He said that you can only 2 times. Moreover, I am young, and there are no problems.

        Reply
        • Svyatoslav Gennadievich:

          Hello! This is from the category: you can not eat 6 times a day (depending on what, in what quantity and how). In general, brushing your teeth is good after eating - this is the norm. Moreover, modern standards recommend brushing your teeth with irrigation with a special irrigator to clean the interdental spaces.

          What I would like to say as opposed to your doctor: there are toothpastes that I would not recommend brushing once a day. For example, whitening pastes are generally contraindicated for some people. At the same time, there are toothpastes with low abrasion, that is, safe for enamel. It is advisable for people with sensitive teeth to use just such pastes in combination with a soft toothbrush.

          Professional dentists emphasize the fact that after eating you need to remove food debris and plaque to avoid tooth decay and gum disease. I advise you to check with your dentist which toothpaste is suitable for your enamel. When they limit themselves to brushing their teeth, then questions begin: what should be treated first of all, caries or gums? ..

          Reply
  4. Olga:

    Poke some doctors with their nasty face in this article! Year! For a whole year I went to various doctors, telling them about pain in the tooth after chewing hard food - they said that everything was in order. As a result, they waited because of them that the tooth began to hurt after any food. She came again, and they tell me that everything is in order with the tooth! Almost by force she forced the doctor to drill a tooth for herself, and what do you think was there? A tooth completely destroyed from the inside, along with the root! If you have the same situation, go for an X-ray, do not be as trusting as I am. But such doctors need to be fired, without the right to work in the medical field at all.

    Reply
  5. Magamed:

    My teeth are crumbling, what should I do? I have been going to private dentistry for the 5th time, I spent a lot of money. They do not warn about anything until the teeth collapse completely. This is for you to come later and spend normal money again. Tell me a cheap way to avoid tooth decay. And how to protect my teeth, otherwise I’m 21, and my teeth are already breaking. This is already the 6th tooth 🙁

    Reply
    • Svyatoslav Gennadievich:

      Hello! Not all private dentists are "bred" for money, and not in all cases it is in a particular dentistry, even if it seems that more money is being specially extracted from you there.

      There are several simple but effective recommendations: 1. If you are not happy with the tactics of the doctor or the clinic, change the doctor or clinic; 2. If you want to protect your remaining teeth from the effects of caries - do prevention.

      For greater cost savings, prevention can be carried out in state dentistry, but the doctors who work in them are often full of work and very little time. As a result, quality can suffer, so the best option is a normal private clinic, where the doctor has plenty of time for your money.

      Prevention of private individuals who are as interested as possible so that tooth decay does not go into complications and so that it does not appear on the teeth at all is not cheap. The fact is that for the cleanliness of the teeth, regular removal of dental cameos and plaque is required: for example, a stone is removed once every six months. The dentist will determine which spots are caries and which are pigmentation. Initial caries (in the spot stage) can be treated without a drill - the ICON method (not the cheapest option). Dark fissures (fossa on molars) can be treated with an invasive and non-invasive method of sealing fissures, although more often these foci of future serious caries after excision with a drill are simply sealed with light-cured material.

      When all this is done, the best recommendation after a thorough preparation of the oral cavity for use is the competent maintenance of dental health, namely optimal hygiene. This includes: the selection of toothpaste with its alternation, brushes, irrigator for cleaning interdental spaces. An irrigator is a cool thing, many dentists consider an irrigator for home use the best way to prevent caries on the contact walls of teeth. As a practicing dentist, I will say that tooth decay most often just on the walls and develops, right near the gums, where there is a constant collection of food. The irrigator "knocks out" all the remnants of food.

      Hygiene is indicated every time after eating. Teeth fluoridation is shown 2-3 times a year according to indications. For some people, dentistry is the same category of expenses as for women hairstyles and nail beauty - that is, an indispensable component of the normal course of life. So go for it!

      Reply
  6. Zheka:

    Everything is very interesting and detailed! Thank you for the extensive information with the photos!

    Reply
  7. Jena:

    I really liked the doctors, very good, thanks.

    Reply
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