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Pits and Fissures in Teeth

What are Pits and Fissures in Teeth?

Sectioned tooth shows fissure smaller than single toothbrush bristle, making it difficult to clean.

Pits and fissures in teeth may be too deep and narrow to allow access for even one toothbrush bristle, as illustrated by this cross section of a tooth.

Deep pits and fissures in teeth are of concern because food, bacterial plaque, and acids get into them, but toothbrush bristles may not. This frequently results in tooth decay (caries), even in a patient who takes good care of their teeth. An estimated 80% of tooth cavities originate in a deep pit or fissure.

How does the dentist diagnose Pits and Fissures in Teeth?

Note: ToothIQ.com contains general information. Only a dentist can properly diagnose your specific condition.

A dental explorer on a tooth.

Dental explorers have been used for many years to detect early decay of teeth.

Dental professionals inspect the pits and fissures in teeth to determine whether a patient can clean them effectively, whether they have developed tooth decay, and how best to treat the grooves if treatment is necessary. Frequently, a fine-tipped instrument called an explorer is used to assess the depth and stickiness of deep pits and fissures in teeth. For many years, it has been one of the primary diagnostic tools used to detect early decay in pits and fissures of teeth that may not be evident on X-ray images.

Laser caries detection enables tooth decay to be diagnosed without using X-rays.

An artist’s rendering of the tip of a laser fluorescence caries detection meter emits a focused beam of 655nm wavelength light into the pits and fissures, causing fluorescence of decayed tooth structure. The amount of fluorescence is directly related to the size of the cavity. Healthy tooth enamel does not fluoresce.

A more recent and extremely sensitive diagnostic tool for determining whether the pits and fissures in teeth have begun to decay at their base is the laser flourescence caries detection device, the tip of which is shown in the photograph below. Healthy teeth do not fluoresce, and decayed teeth fluoresce in proportion to the amount of bacteria present in the tooth. This device measures the fluorescence pattern of teeth, and produces a reading on a meter which is recorded by the dentist.

Diagnosis of pit and fissure cavities may be most effective when a combination of visual/tactile examination, use of laser fluorescence caries detection devices, and X-ray images (radiographs) are used.

How are Pits and Fissures in Teeth treated?

Common dental procedures related to the treatment of pits and fissures in teeth generally involve minimally invasive techniques. Included among these procedures are dental sealants, topical fluoride treatment, and prophylactic odontotomy. If a deep pit or fissure extends into the dentin layer of the tooth, a filling may be prescribed. None of these treatments is a substitute for proper diet and oral hygiene.

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Author: Thomas J. Greany, D.D.S. / Editor: Ken Lambrecht

This page was last updated on March 2, 2018.

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