Tuesday, November 14, 2006
Can a tooth get a cavity before it even erupts into the mouth? Well, in a bacteriological sense, no, but I occassionally see an odd occurance where there is evidently a large radioluscency(dark area) in the coronal (top) part of a unerupted tooth that indicates loss of tooth structure like a cavity would appear. What is it? Technically it cannot be a cavity as that is caused by a bacteriological process. There are no cavity causing bacteria associated with an unerupted tooth. This is due to some kind of abnormal internal resorptive process. The cells in the developing tooth dissolve the tooth from the inside out in a pattern similar to a cavity. When the tooth actually erupts, bacteria go right to the area and starts an actual decay process. So, basically you end up with a really big cavity rapidly. It is necessary to treat these teeth early and agressively. Sometimes they even need a root canal or removal. It's a pretty odd thing to see on an x-ray if you understand the normal decay process. This is not to be confused with developmental defects in the enamel like Enamel Hypoplasia, which is quite common. It is probably more similar to Internal Resorption , which starts in the pulpal tissue rather than the coronal area, but I have to say I don't really know for sure what causes it.