Deep Dental Decay: Filling, Root Canal, or Extraction?

Dental enamel is the hardest substance in your body, but it’s not perfect. You can still get cavities if you don’t practice good dental hygiene.

If you have cavities that reach deep into the tooth, you and the dentist need to consider which treatment method — a filling, a root canal, or an extraction — is best to restore your oral health.

At Laguna Vista Dental, Dr. Krystle L. Fenton and our expert dental team treat deep decay in patients at our Elk Grove, California, office. How we treat it depends on the state of your tooth and your overall oral and general health. Here’s what can happen.

5 stages of tooth decay

Whether your tooth requires a straightforward filling or needs a deeper, endodontic treatment like a root canal or extraction depends on where it fits on the spectrum of the five stages of tooth decay. 

Stage 1: Enamel demineralizes

You develop small, chalky-white spots on the tooth, which indicate a mineral breakdown of the enamel. 

Stage 2: Enamel decays

Left untreated, tooth decay worsens and ultimately breaches the enamel, creating a hole (cavity). The chalky-white spots also turn a light brown.

Stage 3: Dentin decays

When decay reaches this inner layer, sticky plaque and bacteria combine to increase the rate of cavity development. In addition, you may notice tooth sensitivity, and the light brown spots may turn darker.

Stage 4: Pulp becomes damaged

If the decay still goes untreated, you’ll most likely develop a toothache and inflammation of the gums around the decayed tooth and the pulp (connective tissue and nerve). The dark brown spots now turn black.

Stage 5: Abscess develops

At this stage, you have a deep cavity or an abscessed tooth (pus-filled cyst), neck or face swelling, and intense pain radiating outward from the tooth. If left untreated, the infection can spread to other areas of your body.  

Restorative dentistry can preserve your natural teeth

It’s always preferable to save a natural tooth than to replace it with a restoration. When you have dental decay, time is of the essence to keep the tooth healthy. That’s where restorative dentistry comes in, and we have three options.

1. Filling a cavity

If your tooth is in the early stages of decay, a dental filling resolves the issue unless you already have a large filling or several smaller ones. In the latter case, you might require a dental crown.

During the first appointment for crown placement, Dr. Fenton removes the decay from the hole and preps the tooth for the crown by shaving off a tiny layer of enamel so the crown will sit properly.

Next, she makes an impression of the tooth and sends it to a dental laboratory to fabricate your custom crown. She installs a temporary crown until the permanent one arrives. At your final appointment, she removes the temporary crown and places the permanent crown, and you’re good to go.

2. Performing a root canal

If the pulp has become infected, you’re probably in great pain. A simple filling won’t fix the problem — you need a root canal procedure. 

During a root canal procedure, Dr. Fenton removes the infected or damaged pulp from the tooth, not only in the pulp chamber but also in the 1-3 canals that stretch from the chamber to the root tip. She cleans and disinfects the area and ensures the inner tooth is dry and free of lingering toxins.

She completes the procedure by filling the inner tooth space with a rubbery material called gutta percha and sealing paste. Finally, they make an impression for a dental crown to fully restore the damaged tooth. 

Extracting a tooth

If you have severe decay, gum disease, or an iunchecked infection, your tooth may not be able to be saved and need an extraction. 

Extracting a tooth to save your teeth may seem counterintuitive, but extractions can keep your other teeth (and the rest of your body) healthy. Extracting a severely infected tooth prevents bacteria from spreading to other teeth and other parts of your body.

The best way to prevent decay from getting out of hand is to come to Laguna Vista Dental for twice-yearly check-ups; early detection keeps problems manageable. To make an appointment, call the office at 916-269-6085 or book online today.