Dental treatments are aimed at teeth that, for various reasons, no longer fulfil their role in chewing, phonation or aesthetics. This can be the result of trauma leading to loss of substance or carious lesions, most commonly.

Carious lesions occur in areas that are difficult to sanitize or have sharp relief and can easily retain food.

Regardless of how thoroughly oral hygiene is carried out, it must be complemented by secondary means such as flossing and mouthwash.

Also, at least twice a year, with variations in the patient’s predisposition to tartar formation, hygiene should be carried out professionally by the dentist and consist of scaling, professional brushing and the application of fluoride gels or pastes in patients with a marked predisposition to developing caries.

When a dental unit is affected by a caries or traumatic process or any other potentially damaging agent, changes do not only occur in the superficial layers of the teeth.

More often than not, surface changes are the consequence of those produced deep down in the dental pulp.

The pulp chamber is protected by dentin and enamel and plays a role in nourishing and maintaining the vitality of the tooth.

Being connected to all the dental layers and rich in receptors, it is what ensures the sensitivity of the tooth.

Depending on the aggressor, the pulp responds differently:

Pulpal hyperemia – is when a carious process is present in a tooth, deep enough to produce sensitivity but still at a considerable distance from the pulp chamber.

Thus, the tooth will be more sensitive when the patient consumes liquids or sweet or cold foods.

Even if the caries process has not reached the pulp chamber, there are early pulpal manifestations.

In the case of hyperemia, this takes the form of an increase in the number of cells, in order to act effectively against bacterial attack.

Pulpitis – if the carious process reaches very close to the pulp chamber or even opens it, the changes at this level are different from those in hyperemia.

Thus, the number of cells involved in the defence is reduced, thus the ability to fight the aggressor gradually decreases.

The pain intensifies, and soon necrosis or gangrene may be reached if the tooth is not treated in time. Necrosis or gangrene are entities that suggest that the tooth has completely lost its vitality.

Pulp necrosis – some chemical substances during treatments or accidentally getting into the vicinity of the dental units or excessive forces applied to the teeth especially in the case of orthodontic appliances can cause death of the dental pulp.

It is important that during endodontic or periodontal treatments the concentrations and dosages indicated by the manufacturer are observed to prevent such accidents.

Also, a large proportion of patients who come to the dentist’s surgery want their teeth whitened.

It is important that these are done under the supervision of the doctor, because often the concentrations found on the market are increased and can cause sensitization of the teeth or even necrosis.

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