Tooth Decay Treatment
How cavities form and how they are treated, from fillings to crowns.
Tooth decay is caused by acid-producing bacteria. Caught early it needs a simple filling; advanced decay may need a crown or root canal.
Treatment by Stage
Early decay: filling. Deep decay: root canal and crown. Severe: extraction and implant.
Prevention
Good brushing, flossing and regular check-ups prevent decay.
Decay Is a Process, Not an Event
Bacteria metabolise sugar and produce acid. Acid dissolves mineral out of enamel. Saliva puts mineral back. Decay occurs when, over months, the first outpaces the second.
That balance is why frequency matters more than quantity. Six coffees with sugar sipped across a day cause more damage than a dessert eaten in ten minutes, because each sip restarts the acid attack.
The Earliest Stage Can Be Reversed
A white spot lesion is demineralised enamel with the surface still intact. It can remineralise: high-fluoride toothpaste, reduced snacking frequency, fluoride varnish, and in some cases resin infiltration. No drill.
Once the surface collapses into a cavity, that door closes. Enamel does not regenerate. Everything after this point is restoration, not healing.
Treatment by Depth
Enamel only: remineralisation or a small filling.
Into dentine: a filling — composite bonded, or an inlay/onlay if large.
Close to the pulp: selective removal and a protective liner, hoping the pulp recovers.
Into the pulp: root canal treatment, then cuspal coverage.
Below the bone: usually extraction.
Each stage costs several times the one before. Decay is the cheapest disease to treat early and one of the most expensive to ignore.
Why It Does Not Hurt Until It Is Serious
Enamel has no nerves. Dentine gives brief sensitivity. Pain arrives only when the pulp is inflamed — by which point a filling is often no longer enough.
Absence of pain is not absence of decay. It is the reason for check-ups and bitewing radiographs, which show decay between teeth long before you feel it.
Prevention That Actually Works
Fluoride toothpaste, twice daily. Spit, do not rinse — rinsing washes away the fluoride you just paid for. Interdental cleaning daily; most decay in adults starts between teeth. Reduce the frequency of sugar, not only the amount. Beware sugar-free fizzy drinks: they cause erosion, not decay, and dissolve enamel just the same.
Dry mouth from medication substantially raises risk — see dry mouth. Discuss high-fluoride toothpaste with your dentist if you are affected.
This page provides general information and does not replace professional dental advice. Always consult a qualified dentist about your individual case.
Frequently Asked Questions
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