Evolution of Tooth Decay: Your Treatment Options

Cavities, tooth decay, or “caries” come in all shapes and sizes. The great news is that when you know what to look for, you can intercept them before the bacterial infection spreads any further into your tooth. The earlier you treat the decay, the more tooth structure you’re able to preserve.

Enamel Demineralization

The very first stage in tooth decay is what we call “demineralization.” It’s where plaque bacteria sit on your tooth for too long and the acid begins to erode your enamel. If you’ve ever seen white spots on your teeth, it may be demineralization.

Fortunately, with improved oral hygiene and fluoride applications, you can stop tooth decay at this stage and remineralize the tooth. You’re essentially reversing the cavity process before it physically creates a hole in your enamel.

Incipient Tooth Decay

If demineralization goes unchecked, you’ll develop what we call incipient decay. These are extremely small cavities that are restricted to the outermost layers of your enamel. Depending on the location and characteristics of these cavities, they could require a small filling or just a “watch” placed on them. With a watch, we monitor the area at each of your checkups to ensure that it hasn’t progressed any. It’s essentially a “wait and see” approach if the decay is not quite far enough into the tooth to justify treatment.

Small Cavity

Once it’s obvious that the cavity has worked its way into your enamel, we may be able to physically see the decay during your exam or on an X-ray. At this point it’s no going back. The bacterial infection has compromised your tooth integrity and will continue to spread. Placing a small filling is your only option.

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Medium to Large Cavity

If your filling appointment is delayed, the caries will continue to spread deeper into your tooth. In fact, it might even “jump” to adjacent teeth at the same time. It’s at this point where it’s crucial to treat the decay before a painful abscess even comes onto the radar.

Medium-sized cavities are usually repaired with a large filling. Depending on which part of your tooth is involved, this could be a 2-3 surface filling. An example would be on the chewing surface extending onto the side of your tooth and also back into the contact point where the tooth touches its neighbor.

At some point that medium cavity will become a large one. When the decay is large, a filling is no longer an option. Why? Because there needs to be enough intact enamel to enclose the filling and hold it in place. Otherwise applying biting pressure would cause your tooth to break apart. What option is left then, you ask? A full coverage crown.

Crowns cover the entire tooth, protecting the compromised structure and allowing you to continue biting/chewing normally.

Large Decay with Nerve Involvement

Once a cavity has worked its way through the tooth far enough to involve the nerve tissues inside of it, the life of your tooth is jeopardized. It is simply a matter of time before the nerve abscesses and begins to die. There is not a viable option for treating the nerve and preserving it. Fortunately, you can still save your tooth and avoid an extraction by performing a root canal on it. During a root canal we remove the nerve and fill the hollow chamber inside of it, blocking off any path for bacteria to spread down into your bone.

Aggressive Caries

At a certain point, decay can take over so much of your tooth structure that there’s nothing left to restore. If the cavity has eroded most of your anatomical crown (the part above your gums) and down into the roots, restoration is no longer an option. Once you’ve reached this stage, the only choice is to remove the tooth altogether and then replace it with something like a dental implant or bridge. Surprisingly, aggressive decay may not even be accompanied by pain because the nerve of the tooth is no longer vital.

Think You Have a Cavity? Call Our Mesa Dentist

Eastport Dental offers a wide range of treatment options for your family’s needs. If you have a cavity, the best thing to do is treat it as early as possible, before the decay spreads any deeper into your tooth. Remember that not all cavity symptoms are noticeable, so even if something feels a bit “off” you need to go ahead and have it checked out.

Call our Mesa dentist today for an appointment!

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