HIDDEN DENTAL DISEASES: WHY A TOOTH MAY APPEAR HEALTHY BUT DESTRUCT FROM WITHIN

Abstract

An externally intact tooth crown is often mistakenly interpreted as a sign of complete health. However, there is a whole group of pathological conditions in which macroscopically unchanged enamel conceals progressive dentin destruction, resorption of the pulp cavity, or incomplete fractures of hard tissues. Such “hidden diseases” include proximal and fissure caries with a preserved surface layer, internal inflammatory resorption, replacement resorption, cracked tooth syndrome, subenamel demineralization at the “white spot” stage, as well as hidden defects after endodontic treatment. The article examines in detail the etiology, pathogenesis, epidemiology, clinical manifestations, diagnostic algorithms, and modern imaging methods (including OCT, CBCT, micro-CT, laser fluorescence, and transillumination). Clinical cases are presented and treatment principles are discussed. The aim is to increase dentists’ vigilance regarding subclinical forms of hard tissue destruction of the tooth.