Caries of the Molar Teeth: What Is Fissure Caries

Dark spots on the molar teeth are usually noticed by chance — at home, in front of a mirror. And immediately the question arises: is it caries or something else. We explain step by step what caries of the molar teeth is and its separate type — fissure caries.

What Is Caries of the Molar Teeth

Caries is a chronic disease of the teeth. Bacteria in the mouth process sugar and starch from food and drinks and release acids that destroy the enamel. Enamel consists almost 96% of minerals, mainly hydroxyapatites, and its destruction begins already at pH 4.5. First a white spot appears — an area where minerals have been lost. This is an early sign, and at this stage the process can be stopped or reversed. If it progresses further, the enamel is weakened, the dentin is destroyed, and a cavity forms — a hole that the doctor fills with a filling. Without treatment, the inflammation spreads to the pulp and periodontium.

Why Caries More Often Appears on the Chewing Surface

Caries is the most common human disease, affecting over 93% of people. It is not about chewing, but about anatomy. On the chewing surface of the molars there are natural fissures. In them, as in the spaces between the teeth, there are favorable conditions for long-term fixation of dental plaque. Plaque is a sticky film of bacteria, and it is poorly cleaned from a narrow groove with a brush. Soft, carbohydrate-rich food and a small amount of viscous saliva help bacteria to attach. Saliva and fluoride help the enamel restore minerals.

For children there is a separate measure — sealants: thin plastic coatings that protect the chewing surfaces of the posterior teeth. They are placed as soon as the tooth erupts.

Fissure Caries: How It Looks and Manifests

Fissure caries is caries that begins in the natural fissures on the chewing surface. Externally it is revealed by spots on the tooth surface, but at the beginning caries may produce no symptoms at all. Later the following appear:

• toothache;
• sharp pain with hot, cold, or sweet;
• white, brown, or black spots on the tooth surface;
• a noticeable cavity — a hole.

How Caries in the Fissures Is Detected

What happens at the appointment: the doctor examines the teeth and probes them with dental instruments, asks about complaints — whether the tooth reacts to cold, sweet, hot. Sometimes an X-ray is needed: it shows what is not visible to the eye. There are also tests — enamel staining, assessment of plaque and traces of bacteria, checking the resistance of hard tissues to acids. This is how it is determined whether a person's resistance to caries is high, medium, or low.

Complications of Untreated Caries

If the cavity is not filled, the destruction goes deeper. Reaching the soft tissue in the center of the tooth — the pulp — it causes inflammation. Then comes infection. It can lead to an abscess, a collection of pus: this means pain, facial swelling, and fever. The statistics are as follows: 95–98% of adults have filled teeth, about 80% of adolescents finish school with carious cavities. Advanced caries is the cause not only of an unsightly hole, but also of tooth loss.

When to See a Dentist

You should see a dentist if a tooth hurts, if there is sharp pain when eating or drinking, if the gums hurt, swell, or bleed when brushing. If, against the background of a painful tooth, facial swelling appears and the temperature rises — this is a reason to urgently see a dentist. And even without complaints, regular dental check-ups are needed; how often to come will be advised by the doctor. A dark spot or stain in a groove is also a reason to see a doctor. What will be offered is decided by the doctor after the examination.

Fissure caries by itself is not a reason to call an ambulance; 103 or 112 is dialed in life-threatening conditions.

I remind you: this is reference material, and it does not replace a doctor's consultation — only a dentist at an appointment can make a diagnosis and choose the approach.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer