What happens if I do not take care of a cavity????

What happens if I do not take care of cavities?

Your general dentist can detect cavities, a.k.a “caries”, with a combination of an oral exam and x-rays.  Once a cavity is detected it must be cleaned and filled properly, it will not just go away spontaneously.

The process of cleaning a cavity begins with removing the infected and decayed enamel and dentin.   The remaining defect in the tooth is then sterilized and filled with a material that is bonded to the tooth.  The filling material is designed to imitate the natural anatomy of the tooth, so that it can withstand the forces of chewing and occludes properly.  But no matter how good the technology,  and the latest advances in nano-technology (white resin fillings) we can never 100% mimic the natural tooth.  That’s why its so important to prevent cavities from occurring in the first place.

Some people chose to not to follow the recommendation of their general dentist, and hope that the cavity will spontaneously get better.  On the contrary, if the cavity is not removed, it will worsen and go deeper into the pulp chamber of a tooth, leading to further need for a root canal.  The more delay, the more the discomfort and financial burden.

A tooth typically have 5 surfaces: occlusal (chewing), lingual (tongue), buccal (cheek), mesial (front) and distal (back).  If too many surfaces of the tooth are affected, the strength of the tooth can be compromised making it unethical to fill the cavity.  At this point the tooth might crack or even break.  In this case, we need to place a crown (cap) on the tooth.  Depending on the number of surfaces involved, there are different codes signifying the amount of work that needs to be done.  In general the more surfaces, the more complicated the filling procedure and the more expensive the treatment.

A crown is typically placed with there is little tooth structure left to just fill it.  The crown is designed to hug the tooth like a winter hat, basically a molded replica of the tooth.  Crowns are fabricated in a lab from a mold (an impression) of the original tooth.  The natural tooth first is prepped (cleaned of decay) and then the crown is securely glued to the prepped tooth.

Sometimes the tooth has been so severely decayed that it has infection has spread to the pulp chamber or the root.  This is when the pain and facial swelling can become unbearable and dangerous.  At this point the material inside the pulp chamber must be removed via a “root canal” procedure.  This is most commonly done by an “Endodontist”(a dentist who specialises in root canal therapy).  Most commonly your general dentist will refer you out for this procedure. The endodontist will first empty the pulp chamber of the infected material, sterilize it, and fill it with a special inert material that prevents future infections.  In the majority of the cases where a tooth has been root-canaled, a crown is need on the tooth to protect the tooth and its new root canal.  On occasion, some patients forgo the crown placement after a root canal, in order to save money.  Unfortunately this habit will only lead to further problems in the future, such as a fracture of the tooth and/or the eventual loss of the tooth.

In some instances, if the tooth is severely compromised, or is cracked below the gum-line (sub-gingival), the tooth must be extracted to prevent further spread of the infection into the head & neck area.  This can sometimes be life-threatening, as a result of difficulty in breathing.  There have been several documented cases of people dying from non-treated infected teeth.  People of all ages, races and ranges of health and fitness have been affected, so it is not safe for anyone to ignore the hazards caused by tooth decay.  Make sure to schedule your bi-annual evaluations in order to get screened for potential oral health issues.

Most well-trained general dentist can pull a simple tooth.  However with more complicated procedures and teeth with multiple roots, it is more common for the dentist to refer you to a specialist, or an Oral Surgeon.  An Oral Surgeon has special equipment and training to make extraction more safe and comfortable, in a lot less time.  An oral surgeon at a minimum has 4 extra years of training in just the extraction teeth, see our previous post “What Is Oral Surgery” for more information on the education and training of an Oral Surgeon.

Once a tooth is extracted, it should be replaced in order to recreate the harmony that typically exists in out dentition.  In addition to being unsightly, the missing tooth will cause the other teeth to shift and cause misalignment (malocclusion) of the teeth.  Teeth can be replaced with either a bridge or an implant.  Please refer to our previous article “What Is A Dental Implant” for more detailed information about bridges and implants.


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