Cavities/tooth decay

Diagnosis

Your dentist can usually detect tooth decay by:

• Asking about tooth pain and sensitivity
• Examining your mouth and teeth
• Probing your teeth with dental instruments to check for soft areas
• Looking at dental X-rays, which can show the extent of cavities and decay

Your dentist will also be able to tell you which of the three types of cavities you have — smooth surface, pit and fissure, or root.

Treatment

Regular checkups can identify cavities and other dental conditions before they cause troubling symptoms and lead to more-serious problems. The sooner you seek care, the better your chances of reversing the earliest stages of tooth decay and preventing its progression. If a cavity is treated before it starts causing pain, you probably won't need extensive treatment.

Treatment of cavities depends on how severe they are and your particular situation. Treatment options include:

• Fluoride treatments. If your cavity just started, a fluoride treatment may help restore your tooth's enamel and can sometimes reverse a cavity in the very early stages. Professional fluoride treatments contain more fluoride than the amount found in tap water, toothpaste and mouth rinses. Fluoride treatments may be liquid, gel, foam or varnish that's brushed onto your teeth or placed in a small tray that fits over your teeth.
• Fillings. Fillings, also called restorations, are the main treatment option when decay has progressed beyond the earliest stage. Fillings are made of various materials, such as tooth-colored composite resins, porcelain or dental amalgam that is a combination of several materials.
• Crowns. For extensive decay or weakened teeth, you may need a crown — a custom-fitted covering that replaces your tooth's entire natural crown. Your dentist drills away all the decayed area and enough of the rest of your tooth to ensure a good fit. Crowns may be made of gold, high strength porcelain, resin, porcelain fused to metal or other materials.
• Root canals. When decay reaches the inner material of your tooth (pulp), you may need a root canal. This is a treatment to repair and save a badly damaged or infected tooth instead of removing it. The diseased tooth pulp is removed. Medication is sometimes put into the root canal to clear any infection. Then the pulp is replaced with a filling.
• Tooth extractions. Some teeth become so severely decayed that they can't be restored and must be removed. Having a tooth pulled can leave a gap that allows your other teeth to shift. If possible, consider getting a bridge or a dental implant to replace the missing tooth.

Preparing for your appointment

If you're experiencing pain or sensitivity in your teeth, make an appointment with your dentist as soon as possible. Here's some information to help you get ready for your appointment.

What you can do

Before your appointment, make a list of:

• All medications, vitamins, herbal remedies or other supplements you're taking, and dosages
• Any allergies to medications or bad reactions you've had to local anesthetics
• Questions to ask your dentist

Basic questions to ask your dentist may include:

• Do I have a simple cavity, or do I need a crown or a root canal?
• How many visits will it take to treat this tooth?
• When will the pain go away?
• What can I take for the pain?
• How long should I wait before I eat or drink after this procedure?
• Are there other steps I can take to prevent cavities?
• Does my local water supply contain added fluoride?
• Are there any brochures or other printed material that I can have? What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your dentist

Your dentist may ask you some questions. Be ready to answer them to save time to go over topics you want to focus on. Questions may include:

• Do extremes in food temperature or sweet foods cause you pain?
• Does biting down make your pain worse?
• How often do you brush your teeth?
• How often do you floss your teeth?
• Do you use toothpaste that has fluoride?
• Do you eat a lot of sweets or drink sugary beverages or sodas?
• Have you noticed dryness in your mouth?
• What medications do you take?

What you can do in the meantime

While you're waiting for your appointment, you can take some steps to control your tooth pain. For example:

• Take an over-the-counter pain reliever, if your doctor has said it's OK for you.
• Use an over-the-counter anesthetic specifically designed to soothe painful teeth.
• Use warm water to brush your teeth.
• Use toothpaste designed for sensitive teeth.
• Thoroughly clean all parts of your mouth and teeth — don't avoid painful areas.
• Avoid foods or beverages that are hot, cold or sweet enough to trigger pain.