Cavity Treatment Options: Fillings, Sealants, and Beyond

When we head to the dentist for our twice-annual cleanings, the lingering worry in our minds is if a cavity has developed or progressed since our last visit. Cavities are among the most common dental conditions — the result of plaque buildup and acids in the mouth that erode the tooth’s hard outer layer called the enamel. This leads to a loss of hardening minerals in the tooth, and it begins to collapse. 

Anyone can get a cavity, but proper oral hygiene and regular dental cleanings are highly effective preventive measures. More than 80 percent of Americans develop at least one cavity before their mid-30s. Fortunately, for that large percentage of the population who will develop a cavity, there are treatments to prevent it from worsening and leading to a root canal. 

How are cavities detected?

Cavities can occur on a tooth's surface but are also found in between teeth. Those that occur on a tooth’s surface can be detected through a visual examination by your dentist. They will look for abnormalities compared to your healthy, natural teeth. However, since cavities can also occur between teeth, your dentist will need annual X-rays to look inside the teeth where a problem may be occurring. A physical examination combined with X-rays will allow your dentist to see if a cavity is present anywhere. 

From the patient’s perspective, a cavity might be suspected if you are experiencing a toothache or mouth pain, bad breath or a bad taste in your mouth, bleeding gums, facial swelling, or sensitivity to hot or cold foods and liquids. Any of these symptoms require a visit to your dentist, especially if you’re not due for a cleaning in the very near future.

What are the stages of a cavity?

There are three stages of a cavity, with treatment options that vary depending on the stage. As with most medical issues, early detection is the key to a treatment that is less invasive and more comfortable. 

The stages of a cavity are:

• Stage 1 – The very beginning of a cavity with a slight defect of the tooth, and often watched closely along with using a higher fluoride toothpaste. 
• Stage 2 – The cavity has penetrated the dentin inside the tooth and is now moving rapidly towards the root. This is the stage at which fillings are needed.
• Stage 3 – Bacteria has reached the center of the tooth where the nerve and blood vessels live, most often requiring a root canal and crown. 

How can I prevent cavities?

Preventative treatments include proper oral hygiene, regular cleanings with your dentist, and sealants. Sealants are a thin coating that is painted onto each tooth, cured to harden, and then protects your teeth long-term from cavity-causing bacteria. They are typically applied to teeth in childhood or adolescent years to prevent cavities. However, they can also be applied to adult teeth that are in good condition and without any fillings. 

Stage 1 cavities are often monitored by a dentist, with a recommendation to use a high fluoride toothpaste. Stage 2 cavities require a filling, which stops the progression of the cavity, saves the affected tooth, and avoids a painful and costly root canal. Cavities that have progressed further require more invasive treatment.  

• Fillings – Dental fillings are the most common course of treatment when a cavity is identified that has not yet reached the root. Your dentist drills out the decayed tissue and fills the hole with a filling that consists of durable composite resin, which is a tooth-colored material that is unnoticeable. Alternate types of fillings are silver, gold, and ceramic, but those are more cost-prohibitive and used less often than composite. Fillings occasionally require maintenance but usually remain intact with proper dental hygiene and avoidance of extremely coarse or hard foods.
• Root canal – Typically performed by an endodontist, a root canal relieves pain from advanced tooth decay by removing the inflamed and infected tooth pulp inside the tooth. The endodontist will carefully clean and disinfect the tooth, and fill the canals with a special filling material. This process eliminates the bacteria and saves the natural tooth. In many cases, a dental crown is needed to strengthen the affected tooth. 
• Extraction – If the affected tooth is beyond the condition in which a root canal can be performed, your dentist might recommend extraction. This process might also require a dental bridge or implant to replace the tooth so that your smile and chewing are not affected.

One of the most important things to know about cavities and fillings is that receiving treatment shouldn’t be a painful experience. If any of your dental procedures come with pain or discomfort, always let your dentist know so they can provide a better experience. Contact us if you would like to learn more about cavities and treatment options.