Tooth Decay Treatment
Dental research has shown that tooth decay (dental caries) can be prevented with simple measures such as brushing teeth with fluoride toothpaste and regular visits to the dentist. But that does not change neither the fact that tooth decay remains one of the most common diseases even in developed countries, nor that it is one of the main causes of tooth loss.
How to treat tooth decay?
The good news are that several treatments of tooth decay are available to either stop the progress of the disease or/and restore the damage caused by dental caries. If tooth decay is diagnosed early, the required treatment can be a small and low cost dental filling. As tooth decay progresses the treatments needed become more complicated and expensive. Regular visits to a dentist every six months can help prevent tooth decay or at least reduce the cost of tooth decay treatment.
Treatments for tooth decay vary depending on the extent and severity of the damage in tooth structures:
If tooth decay is detected at the early stage of ‘white spot’, indicating a mild de-mineralization of the surface of tooth enamel, brushing with fluoride toothpaste and flossing can be enough to stop the progress of tooth decay. Additional fluoride treatments provided by the dentist can also help reverse tooth decay before a cavity is formed. These include the prescription of high fluoride concentration toothpastes and the application of fluoride gels or varnishes at the dental office.
While the acids produced by dental plaque bacteria have not eroded the enamel enough to create a hole (cavity), the tooth can still repair itself with the natural process of re-mineralization if the factors contributing to tooth decay are eliminated. The purpose of using fluoride toothpastes and fluoride supplements is to enhance the enamel’s re-mineralization cycle.
Dental Restoration – Dental fillings or Crowns
If the enamel has collapsed and a cavity is formed or tooth decay has reached the softer layer of dentine, the tooth can not repair itself any more and a dental restoration is required. The dentist will first use a dental drill to remove the decayed tooth material and then will fill the cavity with a restorative material.
- Dental fillings are the most common treatment for tooth decay. Materials such as dental amalgam, gold or composite resin are used to fill the cavity and restore the tooth to its original shape and function, after the dentist has removed the decay.
- Inlays – Onlays are indirect dental restorations (prepared in a laboratory based on a mold of the tooth). They are made of porcelain providing better esthetic result than common dental fillings.
- Dental crowns are used when the decay has damaged the tooth structure in such extend that the remaining part of the tooth’s crown may not withstand the pressure of biting. Large fillings used to replace extensive loss of tooth tissue have increased risk of a tooth fracture. If the structural integrity of the tooth is uncertain, the dentist may decide to use a dental crown (cap) instead of a filling. Crowns are often made of gold or porcelain.
Treating dental caries as early as possible helps maintain the strength of the tooth and limits the chance of damage to the pulp.
Root Canal treatment
Untreated tooth decay can advance through the soft dentine and reach to the pulp chamber in the center of the tooth, infecting the pulp tissue, nerves and blood vessels (pulpitis). The pain becomes very intense and the only tooth decay treatment that can prevent further problems is a root canal therapy. Otherwise the infection can spread through the root canals to the tissues surrounding the tips of the root(s) and cause a tooth abscess.
During a root canal treatment (endodontic therapy) the dentist removes the living tissues from the pulp chamber and the tooth root canals, along with the decayed hard tissues of the tooth. The root canals and the pulp area are filled with a sealing material (gutta-percha). Depending on how extensive is the damage of the tooth; it can be restored with either a dental filling or a dental crown.
A dentist will always try to save an infected tooth with root canal treatment and antibiotic medication. Unfortunately in some cases, when root canal fails or the infection has spread so much that can not be eliminated, the only alternative treatment for tooth decay is the tooth extraction. A decayed tooth may also have to be extracted if after removing the infected parts, there is not enough remaining tooth to support a filling or even a crown.
Tooth Replacement – Bridges / Implants / Dentures
Although dentists consider tooth extraction as the last option for treating a tooth severely damaged by dental caries, some times they have to extract the tooth. If a tooth is extracted, dentists recommend that it should be evaluated for replacement as soon as possible to prevent jaw bone loss. Otherwise, neighboring teeth may change position or loosen. Extracted teeth can be replaced with dental bridges, dental implants or dentures.
- A dental bridge is one or more artificial teeth (pontic), made of porcelain, and used to fill the gap of extracted teeth. They are supported in place by being fused to two crowns fitted on the teeth on either side of the gap.
- A dental implant, usually made from titanium or titanium alloy, is a screw-like fixture which anchors into the jaw bone, playing the role of an artificial tooth root. After the dental implant integrates with the jaw bone, it can be used to support a crown, bridge or dentures.
- If multiple teeth have been lost from tooth decay or other problems, they can be replaced with dentures.
You can avoid to ever needing the treatments described here, if you follow your dentist’s advice for the prevention of tooth decay (brush and floss, avoid sugar, visit your dentist).
Preventing cavities can save you from spending money to restore decayed teeth with dental filling or crowns, or even worse to replace with dentures or implants teeth that are lost due to tooth decay. The best treatment for dental cavities is always the prevention of tooth decay.