Pit and Fissure Cavity

The term cavity or tooth decay has become very popular among our population today. Pit cavities are tiny spots of decay on the teeth which progress to the breakdown of tooth structure and lead to a toothache.

Have you ever thought how this process of tooth decay initiates? Well, this is what today’s article is all about.

Pits and fissures are the results of grooves present on the chewing surface of the teeth. They are more prominent in the teeth at the back and are considered as the prime areas for initiating a tooth decay.

The anatomy of the pits and fissures makes it a delicate area to clean in the oral cavity. They are deep in some patients or have accessory grooves along its course which makes it difficult for a brush to remove the plaque efficiently.

In some cases, where the fissures and pits are too deep, a dentist may recommend the use of sealants which acts as a protective covering over the areas of concerns on the chewing surface of the teeth and make the teeth more cleanable.

Let’s get into the article and learn more about the pit and fissure cavity and the different ways to prevent it and treat it.

What is a pit and fissure cavity?

Pit and fissures are formed as a result of the merging of anatomical grooves present on the chewing surfaces of posterior teeth namely the premolars and molars.

These pits and fissures are usually more profound in the molars as compared to the premolars making it more prone to decay.

Formation of white chalky spots or breakdown of tooth structure indicates the formation of cavities more commonly in the pits. Such a hole is called a pit and fissure cavity.

The center for disease control and prevention surveyed that about 91% of the people in the United States ranging from an average age of 20 to 65 experienced tooth decay within three years due to lack of dental awareness. (1)

How does a cavity develop in the pit and fissures?

When food particles are lodged in these areas of the tooth, they start forming plaque, a thin layer of bacteria. It is also referred to as the home for oral bacteria, which begin the process of demineralization.

Such areas are difficult to be cleaned by a toothbrush, especially when the pits and fissures are deep.

If such area is not cleaned regularly and efficiently, the plaque accumulates. The bacteria convert the sugar in the food into acid.

The process of demineralization continues which leads to the breakdown of tooth structure, thereby forming a cavity.

Signs and symptoms

The earliest sign of a cavity formation is the formation of rough white chalky spots or surface on the pits and the fissures.

If you move your tongue around the chewing surface of your molars, you may feel a rough surface.

When the tooth structures start to breakdown, a soft brown/black spot on the pots or in between the fissures can be seen. A dentist easily detects such cavities during a regular dental check-up.

In severe cases, the cavity widens and involves more tooth structure. It may also deepen and affect the pulp which leads to a toothache and sometimes even leads to abscess formation in the gums.

What can you do to prevent it?

A little attention to your teeth and an excellent oral health care routine can help you keep a regular check on your pit and fissures. (2)

Using a fluoridated toothpaste with a proper brushing technique twice a day especially after you eat a sticky food or sugary meal will help you to reduce the plaque formation around the tooth surfaces.

While brushing, pay attention to the surface of the tooth as well especially the premolars and molars. Check for any changes in the texture of the color of the tooth.

Go for regular dental check-ups. A dentist can detect the lesion at an early stage and suggest you get a professional scaling or the use of a pit and fissure sealant.

Sealants are effective in arresting the pit and fissure caries, especially in young children. (3)

Professional treatment modalities

The treatment of a pit and fissure sealant depends on the extent and the severity of the tooth decay and the time at which the dentist detects the cavity.

If the pit and fissure cavity is detected at an early stage, the treatment may vary from a simple scaling to application of a pit and fissure sealant.

A dental sealant smoothly flows into the pits and fissures of the tooth and makes the surface of the teeth cleansable and free from caries. 

Sealants as a treatment modality are more prevalent among the children on their newly erupted permanent teeth. (4)

But they are also used for adults under the recommendation of a dentist. Evidence has shown that fluoride releasing sealants have a better defensive ability against caries. (5)

In cases where the decay progresses and involves other layers of the tooth, like the dentin, the treatment requires a filling or restoration of the tooth.

The filling is done with certain dental materials like composite or even a tooth crown depending on the severity of the tooth structure involved.

Take away message

The depth and anatomy of the pit and fissures vary from person to person. You have to stay informed and pay attention to your oral hygiene.

Following simple oral care routine daily will efficiently help you to avoid the problem. Always keep a check on the changing conditions of the tooth surface and oral tissues.

When in doubt, always consult a dentist. It is best to follow up for a regular check-up in every six months to avoid extensive decay or a toothache.

Take advice from your dentist and ask for a suitable toothpaste and demonstrate a proper tooth brushing technique.

Stay updated with the current information about cavities and their preventive measure.