92 Where There Is No Dentist 2012
problems you will see most often
CAVITIES AND LOST OR BROKEN FILLINGS
A cavity can occur in any tooth. A cavity can also start around an old filling,
especially if it is dirty. The deeper a cavity gets inside the tooth where the
nerve lives, the more the tooth hurts.
• Pain when drinking water or eating
• A hole (or black spot) on the tooth, or
between two teeth.
• Pain if food gets caught inside the hole.
• No pain when you tap the tooth.
TREATMENT (when there is no abscess):
Try to remove any loose piece of filling with a probe. Then, following the
steps in Chapter 10, put in a temporary or permanent filling.
For a temporary filling:
1. Fill the hole with cement. If you have no cement, put some cotton into
the hole to keep food out.
2. Look for cavities or broken fillings in the other teeth. Fill each one with
cement before it gets worse and starts to hurt.
3. Arrange for someone to replace the temporary filling with a permanent
For a permanent filling:
You will need a person who has experience doing Atraumatic
Restorative Treatment (see page 152) or using a dental drill
(see page 156).
A groove on the neck of a tooth is a more difficult
cavity to fill. For the temporary cement to hold
properly, you need to shape the groove with a drill.
To help temporarily, you can put a little fluoride
toothpaste on the groove (page 211). Do this once
each week until the inside part of the groove is stronger and the tooth hurts
less. Or, you can paint the inside of the groove with oil of cloves (eugenol) to
reduce the pain.
To avoid making the problem worse, (1) do not use a hard toothbrush;
(2) do not brush back and forth along the gums; and (3) do not chew tobacco
or betel nut and do not hold them against the teeth.