Tooth decay treatment: Restore health and beauty to your teeth at Dobrý Dent

Tooth decay (Latin caries dentis) is an infectious disease of hard dental tissues – enamel and dentin. It occurs through a gradual process of demineralization, which is caused by acids produced by bacteria in dental plaque. These bacteria metabolize sugars from our food and, as a by-product, create acids that damage the tooth surface.

Key factors in the development of tooth decay:

• Bacteria in dental plaque: Especially Streptococcus mutans and lactobacilli.
• Sugars in the diet: Carbohydrates serve as food for bacteria. Frequent consumption of sugary foods and drinks increases the risk.
• Poor oral hygiene: If dental plaque is not regularly and thoroughly removed by brushing your teeth and interdental spaces, bacteria have ideal conditions for multiplication and acid production.
• Time: The demineralization process takes time. The longer teeth are exposed to acids, the greater the risk of cavities.
• Individual factors: The quality of the enamel, the composition and amount of saliva (saliva helps neutralize acids and remineralize the enamel), the shape of the teeth and the position of the teeth in the dental arch can affect the susceptibility to cavities.

Tooth decay does not develop overnight, but goes through several stages. Early recognition of symptoms is key to the least invasive and most successful treatment.

1. Initial decay (enamel demineralization): In this stage, the surface layer of the enamel demineralizes. It appears as a white, chalky spot on the tooth. This stage is often painless and reversible – it can be stopped and the enamel remineralized with fluoride preparations and consistent hygiene. Regular preventive check-ups at Dobrý Dent are essential for detecting these early stages.
2. Superficial decay (enamel decay): If demineralization continues, the surface of the enamel breaks and a small hole forms. The decay may appear as a brown or black spot. At this stage, there may not be any pain, but the tooth may be more sensitive to sweets.
3. Intermediate caries (dentin caries): The caries penetrates the enamel to the dentin, which is softer and less resistant than enamel. Caries spreads more quickly here. The patient may experience sensitivity or mild pain when consuming sweet, cold, or hot foods and drinks.
4. Deep caries (near-pulp caries): The caries extends deep into the dentin and approaches the pulp, which contains the nerves and blood vessels. The pain tends to be more frequent, more intense and can be triggered by various stimuli (heat, cold, biting).
5. Complications of tooth decay (pulpitis, periodontitis): If the decay penetrates into the dental pulp, it becomes inflamed (pulpitis). This is manifested by severe, often throbbing pain that can radiate to the surrounding area. Untreated pulpitis can lead to its death (necrosis) and the spread of infection through the root canal to the area around the tooth – bone and the supporting apparatus (periodontitis). This can be manifested by pain when biting, swelling of the face, the formation of a pocket (fistula) on the gum and, in extreme cases, tooth loss.

Accurate and timely diagnostics are essential for successful treatment. At our clinic Dobrý Dent in Prague, we use a combination of proven methods and modern technologies:

• Visual examination and examination with a probe: The basic method, in which the doctor carefully examines all surfaces of the teeth and uses a special probe to verify their hardness and possible defects.
• X-rays (RTG): Necessary for detecting cavities in interdental spaces, under existing fillings or crowns, and for assessing the depth of the cavity. We use digital X-rays with minimal radiation exposure.
• Intraoral camera: It allows us and you to see the condition of your teeth in detail on the screen and better understand the findings.
• Advanced imaging methods (CBCT): In the case of complicated cavities, suspected root canal damage, or when planning more extensive reconstructions, we use 3D CBCT X-rays. This provides a detailed three-dimensional image of the teeth and surrounding structures, which allows for absolutely accurate diagnosis and treatment planning.
• Operating microscope: For maximum precision in diagnosis and treatment, we use a dental microscope. This allows for multiple magnification of the working field, thanks to which we can detect even the smallest cavities and remove only the necessary amount of damaged tissue.

The treatment of tooth decay depends on its extent and location. The goal is always to remove all infected tissue and replace it with a suitable material that restores the function and aesthetics of the tooth.

1. Fluoridation and remineralization

For early caries (white spots), non-invasive treatment may be sufficient. This involves the application of concentrated fluoride varnishes or gels in the office and consistent home care using fluoride toothpastes and mouthwashes. The goal is to stop demineralization and promote the re-deposition of minerals into the enamel.

2. Dental fillings

The most common method of treating caries that have already damaged the tooth structure. The procedure includes:

• Local anesthesia: To ensure the painlessness of the procedure, we use a modern computer-controlled anesthesia system at Dobrý Dent STA (Single Tooth Anesthesia System). This system allows the anesthetic to be applied very slowly and specifically, which minimizes the discomfort associated with the injection and ensures effective anesthesia of only the treated tooth, not the entire half of the mouth.
• Caries removal (excavation): The doctor gently removes all softened and infected tooth tissue. The use of an operating microscope at this stage guarantees maximum precision and minimizes the removal of healthy tissue.
• Cavity preparation: The tooth is prepared for the placement of the filling.
• Filling application: The prepared space is filled with a suitable material. In our clinic, we prefer modern and highly aesthetic materials:
  • Photocomposite fillings (white fillings): They are made of resin material with ceramic fillers. They are hardened with a special light (polymerization). Their main advantage is excellent aesthetics (they can be perfectly matched to the color of the tooth), gentleness to dental tissues (they bond to the tooth chemically, there is no need to remove as much healthy tissue as with amalgam) and the absence of metals. They are ideal for treating both front and back teeth.
  • Glass ionomer cements: They are sometimes used as temporary fillings, underlays for composite fillings or for treating cervical caries or temporary teeth. They release fluoride, which helps protect the tooth from further decay.
• Finishing and polishing: The filling is shaped into the correct anatomical shape to fit perfectly into the bite, and then polished to a high shine.

3. Inlay, Onlay, Overlay

If the loss of tooth tissue is more extensive and cannot be adequately replaced with a direct filling, so-called indirect restorations come into play – inlay, onlay or overlay. These are individually made crown replacements that are manufactured in a dental laboratory (or using CAD/CAM technology directly in the office) and then fixed to the tooth.

• Materials: Most often, highly aesthetic and durable ceramics or composite resin are used.
• Advantages: High precision, durability, long life, excellent aesthetics, perfect reconstruction of the shape of the tooth and chewing surfaces.
• Technology at Dobrý Dent: To make these replacements, we use a modern 3D intraoral scanner. This replaces the unpleasant impression using materials and allows you to create an accurate digital model of your teeth. The data is then sent to the laboratory or processed by a CAD/CAM system, which significantly speeds up and makes the entire process more accurate.

4. Endodontic treatment (root canal treatment)

If the decay has penetrated into the pulp of the tooth and caused it to become inflamed or dead, endodontic treatment is necessary. The goal is to remove infected or dead pulp from the root canals, thoroughly clean, disinfect, and hermetically seal the canals to prevent further spread of infection.

This treatment is often the only option to save a tooth from extraction. At Dobrý Dent, we perform endodontic treatment using an operating microscope, which allows us to view the complex root canal system in detail, ensuring maximum success of the procedure.

5. Dental crowns

After extensive damage from decay or after endodontic treatment, a tooth may be weakened and prone to cracking. In such cases, the manufacture of a dental crown is often indicated, which protects, strengthens the tooth and restores its shape, function and aesthetics. Crowns can be metal-ceramic or highly aesthetic all-ceramic. Here too, a 3D intraoral scanner helps us in planning and preparing the tooth.

6. Tooth extraction (extraction)

Extraction is a last resort, which we resort to only in cases where the tooth is so damaged by decay or its complications that it cannot be saved in any way. Even in this case, we ensure that the procedure is as gentle and painless as possible. We will then discuss with you the options for replacing the missing tooth (e.g. dental implant, bridge).

The best treatment for tooth decay is prevention. By following a few basic rules, you can significantly reduce the risk of developing it:

• Thorough oral hygiene: Brush your teeth at least twice a day with fluoride toothpaste for at least two minutes. Don’t forget to clean between your teeth with interdental brushes or dental floss.
• Proper brushing technique: Ask your dentist or dental hygienist at Dobrý Dent for instructions on the correct technique for brushing your teeth and between your teeth.
• Sugar restriction: Reduce the frequency of consuming sugary foods and drinks, especially between main meals. Beware of hidden sugars in food.
• Regular preventive check-ups: Visit your dentist at Dobrý Dent twice a year for a preventive check-up. Early detection of early caries allows for easier and less invasive treatment.
• Professional dental hygiene: Have regular (usually 1-2 times a year) dental hygiene. Professional removal of tartar and plaque is key to gum health and caries prevention.
• Fluoridation: Use fluoride toothpaste. Your dentist may also recommend other fluoride products (mouthwashes, gels) or perform professional fluoridation in the office.
• Fissure sealing: For children and adolescents, it may be appropriate to preventively seal deep grooves (fissures) on the chewing surfaces of the molars with a special material that prevents plaque buildup and caries.

There are many dental practices in Prague, but at Dobrý Dent we offer a combination of factors that make us the ideal choice for your care:

• Experience and expertise: Our team of experienced doctors and nurses is constantly educating themselves in the latest procedures and technologies. We have been working here for you since 2010.
• Modern technology: We invest in cutting-edge equipment, such as operating microscope, STA computer-controlled anesthesia, 3D intraoral scanner and CBCT X-ray. These technologies allow us to provide more precise, gentle and effective treatment.
• Painlessness and comfort: We understand patients’ concerns and place great emphasis on painless treatment (thanks to STA anesthesia) and the pleasant, calming environment of our clinic in Prague 5.
• Individual approach: Each patient is unique to us. We devote enough time to consultation, explanation of the treatment plan and answering all your questions.
• Comprehensive care: We offer a wide range of dental services under one roof – from preventive care and dental hygiene, through caries treatment and endodontics, to prosthetics, surgery and implantology.
• Convenient location: You can find us in modern premises at Jindřicha Plachty 535/16, Prague 5 – Smíchov, near the Anděl transport hub, easily accessible by public transport and car.

Do not postpone the solution to tooth decay. The sooner the decay is detected and treated, the easier, faster and cheaper the treatment will be. Healthy teeth are the basis not only of a beautiful smile, but also of overall health and well-being.