This preoperative photo of tooth
(A), reveals no clinically apparent decay other than a small spot within the central fossa. In fact, decay could not be detected with an explorer. Radiographic evaluation, (B), however, revealed an extensive region of demineralization within the dentin (arrows) of the mesial half of the tooth. When a bur was used to remove the occlusal enamel overlying the decay, (C), a large hollow was found within the crown and it was discovered that a hole in the side of the tooth large enough to allow the tip of the explorer to pass was contiguous with this hollow. After all of the decay had been removed, (D), thepulp chamber had been exposed and most of the mesial half of the crown was either missing or poorly supported.
It is possible for both tooth decay and periodontal disease to be missed during a clinical exam, and radiographic evaluation of the dental and periodontal tissues is a critical segment of the comprehensive oral examination. The photographic montage at right depicts a situation in which extensive decay had been overlooked by a number of dentists prior to radiographic evaluation. Book my appointment