Dental decay (dental caries) is usually treated by removal of the decay. The remaining tooth structure is shaped to hold the dental filling in place. The filling is placed, contoured and the bite is adjusted to duplicate the shape of the natural tooth.

This is a tooth I recently treated that had what appeared to be a small amount of decay, but actually the tooth ended up with a very large tooth colored dental filling.

We had identified that this tooth needed some treatment almost two years ago. The tooth was not painful to the patient, and she finally agreed to have the decay treated.

Beginning tooth decay

Dental dam before dental filling. The sooner a cavity is treated, the smaller any filling will be.

Tooth decay

Deep tooth decay

Deep tooth cavity

Resin composite filling completed

How far in any cavity has spread will determine if any treatment is necessary, as well as the type of repair needed:

1. If detected early, and if the patient follows through with preventative measures that we coach them with, the damage can be reversible (i.e. it goes away itself) without treatment. With the use of fluoride, preventative dental sealants and good home care the disease may reverse ( i.e. allow the enamel to ‘re-mineralize’).
2. Decay that has spread from the outer dental enamel layer into the softer dentine layer will need treatment. This involves placing a dental filling. The sooner a cavity is treated, the smaller any filling will be. Some dentists still use silver-mercury “amalgams”, but I prefer to use non-mercury tooth colored composite filling material if the size of the cavity is not too large.
3. When a tooth has gone untreated, a filling may not be enough to repair the damage. Often this is when a crown (dental cap) is needed to repair the decayed tooth.
4. If the decay continues unimpeded, it will reach the nerve (the tooth pulp). This is when the patient usually feels a toothache. Pain in a tooth is not a good sign; it just means that the restoration of the tooth may get more expensive.  When the nerve (pulp) is damaged, you will root canal treatment before a filling or crown.
5. If a cavity is left untreated, the tooth may eventually rot and destroy the tooth so that it cannot be repaired. The tooth will need to be extracted. Dental implants, bridgework or a denture will be the next step!

All cavities start out small! Get your dentist to repair them before they do more damage! Have regular check-ups where your dentist can diagnose and repair the dental cavities! The important idea is to treat dental decay first or second category before the tooth needs root canal treatment. This will not only save you money, but also make your teeth healthier.