What is the Best Way to Treat a Decayed Tooth?

Understanding Cavities and Tooth Decay

Cavities, also known as tooth decay, are holes or areas of damage that form on the surfaces of your teeth. They can occur on the crown or root and are often caused by plaque buildup, excessive consumption of sugary snacks, and poor oral hygiene. The sooner a cavity is treated, the better the chances of a successful outcome and maintaining good oral health.

Types and Commonality of Cavities

Cavities can take various forms and affect different parts of the teeth. Smooth surface cavities develop slowly and can sometimes be prevented or reversed with proper oral care. Pit and fissure cavities often start during adolescence and progress rapidly. Root cavities are more common in adults with receding gums, and they are challenging to prevent and treat. More than 80% of Americans have at least one cavity by their mid-30s, making it a prevalent chronic disease across all age groups. Children are prone to cavities due to improper brushing and a diet high in sugary foods and drinks, while adults can also develop new decay around previously treated cavities or due to gum recession.

Symptoms and Causes of Cavities

In the early stages of tooth decay on the outer enamel surface, pain or symptoms may not be present. However, as the decay reaches the dentin and pulp, symptoms such as bad breath, bleeding gums, facial swelling, toothache, or sensitivity to hot or cold foods and drinks may occur. Cavities progress through several stages, from demineralization to enamel breakdown, dentin involvement, pulp infection, and potentially abscess formation. The main cause of cavities is the interaction between bacteria in the mouth, sugary and starchy foods, and the formation of dental plaque. Risk factors for cavities include dry mouth, a diet high in sugary and starchy foods, a family history of tooth decay, gum recession, and previous radiation therapy for head and neck cancer.

Diagnosis and Tests for Cavities

Regular dental checkups twice a year are essential for early detection of cavities. Dentists use various instruments to examine the teeth, and a cavity will feel softer when probed. Dental X-rays can also reveal cavities before they are visible to the naked eye.

Management and Treatment Options for Cavities

The treatment for tooth decay depends on the severity of the condition. Options include fluoride treatments to repair early enamel damage, dental fillings to fill the holes after removing decayed tissue, root canal therapy for advanced decay, and tooth extraction if necessary. Fluoride can reverse the early signs of cavities in the initial stages. Dental fillings can be made of composite resin, silver amalgam, or gold. Root canal therapy is performed by endodontists to relieve pain and involves removing the tooth pulp and filling the canals. Tooth extraction might be recommended when root canal therapy is not feasible, and a dental bridge or implant may be needed to replace the extracted tooth.

Prevention of Cavities

Preventing cavities involves maintaining good oral hygiene, including brushing with a soft-bristled brush and fluoride toothpaste at least twice a day, preferably after every meal, reducing sugary and starchy foods and drinks, daily flossing to remove trapped food and plaque, having dental checkups at least twice a year (more frequently if prone to decay or gum disease), and using dental sealants to protect the chewing surfaces of teeth.

Outlook and Prognosis with Cavities

If tooth decay goes untreated for an extended period, it can lead to significant tooth loss and severe infections. However, most people with cavities do not experience long-term problems when treated promptly. Early detection and fluoride treatments can stop the decay in its early stages. Advanced decay reaching the root increases the risk of tooth loss and painful abscesses.

Living with Cavities and Dentist Visits

If you experience bleeding gums, difficulty chewing, signs of infection, swollen face, or toothache, it's time to call a dentist. You should also have a list of questions for your dentist, such as the cause of the cavity, the best treatment option, ways to reduce the risk of future cavities, potential complications, and recommended oral health products. Prompt and timely treatment is crucial, as even in the early stages of a painful cavity, it is not too late for the dentist to repair it. Dentists typically prefer to save natural teeth but may recommend extraction if the damage is severe. Establishing a trusting relationship with your dentist and following their advice on brushing and flossing can help prevent new cavities and ensure a healthy smile for years to come.