A patient of mine presented to my surgery for routine check up. I found a decay and explained to him his tooth has a cavity and needs root canal therapy. He decided to leave it because he wants to give it a chance to heal. He said: “Bones heal, I cannot see why teeth won’t”
This argument has merit, I must admit, so I decided to write this article answering the questions, why don’t teeth heal, like bone? why do we need to drill the tooth? why do we sacrifice tooth structure to fill it?
Healing process in any tissue needs two important factors:
1- cells, the cells are needed to make part of the tissue with their bodies, and to produce the other extracellular matrix material where these cells will live in. For example in bone, there are the Osteoblasts that produce the bone around them.
2- Blood supply. Any cell in our body needs nutrients, to function, live a happy life and carry out its role.
So why don’t teeth heal?
The outer layer of our teeth is a tissue called Enamel. This tissue is formed by a layer of cells called Ameloblasts, that disappears as the tooth emerges through the gums – Desmolytic stage of their life cycle. So once your tooth emerges through the gum, the factory that builds the enamel is gone.
The enamel has no blood supply. Blood vessels are found in the pulp of the tooth, which is the core within the body of the tooth. hence the enamel and dentine have no blood supply, so they lose the healing power.
More info on healing process here
Teeth unfortunately don’t heal. Make sure you look after what you have. Every bit of tooth lost, is lost forever.
Articles are written by Dr M Hajarat.