What Is a Cavity?

A dental cavity is a hole in a tooth. This is usually caused by a bacterial infection of a tooth that eats away at the enamel. The bacteria thrive in an acidic and sugary environment, which allows them to penetrate deeper into a tooth.

How Did I Get a Cavity?

A dental cavity is caused by either a tooth being broken or cracked or invasion by bacteria. Several factors play a role in the development of cavities. This includes saliva flow, saliva quality, diet, pH of the mouth, acidity of the diet, sugar intake, fluoride use as well as oral health maintenance routine including brushing, flossing, mouthwash use and regular professional dental visits.

How Does A Cavity Get Bigger?

If left untreated, the cavity will spread from the enamel (the hard outer layer of the tooth) to the dentin (the softer inner layer of the tooth). Once the bacteria reach the dentin, they spread very quickly through the tubes that make up the softer dentin layer of the tooth.

Why Doesn’t My Cavity Hurt?

Small cavities don’t cause pain because the nerve of the tooth is in the middle of the tooth, protected by the hard outer enamel layer of the tooth. Once the cavity has entered the softer dentin layer of the tooth, the tooth may start to feel sensitive to cold and sweets as the dentin has tubes that connect with the nerve of the tooth. Once the cavity gets closer to the nerve and the nerve gets infected the tooth will usually start to hurt on its own. Once the nerve has degenerated, it no longer has any feeling and will not hurt until abscess forms under the tooth.

When Will the Cavity Turn into An Infected Root?

This is a harder question to answer. There is no clear answer because every person, and every tooth, is different. The trigger for an infected root is trauma. Bacterial trauma to a tooth leads to an increase in pressure in the tooth. If this pressure gets too much for the tooth, the blood flow to the tooth stops and the nerve begins to degenerate. With a non-vital nerve and a lack of blood flow, it is a perfect area for bacteria to grow unhindered. This is when the root is infected.

What Can I Do to Prevent a Cavity?

The best way to prevent a cavity is regular dental maintenance at home with fluoridated toothpaste and regular professional dental visits. This allows our team to prevent decay and treat it early when it does occur. Also, wearing a mouth guard during sports and avoiding using teeth as tools will help.

I Have a Dental Cavity. What Are My Options?

Depending on the size and shape of the cavity we may recommend a filling, a crown, a root canal or an extraction. For small cavities, we will normally recommend a filling. Larger cavities may require a crown to cover more of the tooth to protect it for the long term. If the decay is in the nerve, then a root canal will be recommended. Sometimes, the destruction of the tooth happens in such a way that no filling can be confidently placed on a tooth. In this case, we would recommend having the tooth removed.

What Is a Dental Filling?

A dental filling, also known as a restorative treatment, is when a tooth is repaired to restore its function. The broken or infected area is cleaned up, removing all the bacteria and biofilms from the area and then the area is modified to help the placement of a filling. The tooth is then desensitized, a bonding agent is placed on the tooth, and then the filling is placed, cured (hardened with a light) and then shaped and polished. We match the shade of the filling with your existing tooth structure and shape it so that it looks like a natural tooth when we are finished.

What Are The Benefits of Fillings?

Fillings restore a tooth to its original function. It removes all of the bacteria from the area and allows the tooth to look and work as it had before a cavity formed.

What Are The Down Sides of Fillings?

We do our best to make sure that the tooth is restored to its original shape and function; however, sometimes small changes to the shape and function may be necessary. Additionally, fillings create an interface between the fillings and the natural tooth which may stain over time. Fillings involve a biological system, so success is not guaranteed. Studies show that success rates are approximately 98% over 2 years and the average life of a filling is 7 years. This means that some fillings may chip, crack, or have some other issue and may require replacement before 2 years and most will require replacement within 7 years.

What Can I Expect From The Treated Area?

Some sensitivity is normal after a filling for the first few days. This is usually sensitivity to cold foods and drinks. Soreness around the injection sites is normal if an anesthetic is used. You will still need to brush and floss the tooth to prevent decay from starting around the edges of the filling.

What Other Procedures Will Be Needed?

Fillings do not last a lifetime so replacement of the filling in the future should be expected. The average life of a crown is 7 years.

What Other Procedures Might Be Needed?

Despite our best efforts, fillings will sometimes require an adjustment after they are placed. Sometimes the bite will need an adjustment because the bite is checked while the area is numb and is not completely accurate. Sometimes a rough spot is noted on the edges of the filling once the anesthetic wears off. This will require an appointment to smooth or adjust the filling. If the filling was close to the nerve, trauma to the nerve may have occurred during filling placement in which case the nerve may become infected. This may require root canal therapy or extraction of that tooth in the future.

What Is A Dental Crown?

A dental crown is a type of dental restoration that completely covers or caps a damaged or decayed tooth. It is designed to restore the tooth to its original shape, size, strength, and function, as well as improve its appearance. Dental crowns are typically made of materials such as porcelain, metal, or a combination of both, and they are custom-fitted to each patient’s tooth. Crowns can be used to treat a variety of dental problems, including large cavities, cracked or broken teeth, and teeth that have undergone root canal therapy.

What Are The Benefits of Dental Crowns?

Dental crowns offer several benefits for patients who require them. Dental crowns provide long-term protection for teeth, can provide strength to a weakened tooth, can provide a strong biting surface in cases where a patient may have bite issues, and crowns can also improve the esthetics of a tooth.

What Are The Downsides of Dental Crowns?

We do our best to make sure that the tooth is restored to its original shape and function; however, sometimes small changes to the shape and function may be necessary. Some patients may experience increased sensitivity in the treated tooth after a crown is placed, and some patients may require a root canal if the damage to the tooth affects the nerve. While crowns are durable, they can still be damaged or dislodged by biting on hard objects or by trauma to the mouth. Depending on the material used, dental crowns may not look as natural as the patient’s original teeth.

What Can I Expect From The Treated Area?

After we have prepared the tooth, some soreness in the gums is normal for the first few days. If you have a temporary crown, it may feel rough, and the bite may feel different. Once the final crown is placed, some sensitivity is normal for a few days. You will need to refrain from biting hard or chewy foods for the first 24 hours as the cement hardens completely.

What Other Procedures Will Be Needed?

Crowns do not last a lifetime so replacement of the crown in the future should be expected.

What Other Procedures Might Be Needed?

During the preparation of a crown, there are several procedures that may be required to help stabilize the crown to be placed. This may include a filling to remove any decay on the tooth with or without a carbon fibre post to anchor the filling to the tooth. The tooth may require some gum surgery to provide room for the crown to sit. The opposing tooth that bites into the tooth to be crowned may also require an adjustment to allow enough space for the crown material. If there is an existing crown on the tooth, that crown will need to be removed to fabricate a new one.

Despite our best efforts, crowns will sometimes require an adjustment after they are placed. Sometimes the bite will need an adjustment. Sometimes a rough spot is noted on the edges of the crown where extra cement may be present. This will require an appointment to smooth the crown. Occasionally, the cement will not fully harden or will harden and then weaken over time, and the crown may come off. If this happens and the tooth and crown are intact, the crown can be recemented back onto the tooth. If there was a filling (core) placed during the crown preparation appointment that was close to the nerve, trauma to the nerve may have occurred during filling placement in which case the nerve may become infected. This may require root canal therapy or extraction of that tooth in the future.

What is Root Canal Therapy?

Root canals are valuable dental procedures used to treat and preserve teeth with badly infected roots. The pulp is the live portion of the tooth that extends into the root and contains nerve endings and tissues. When it becomes infected, patients can experience pain, swelling and even total tooth loss unless treated. Root canals remove the damaged parts of the tooth and infected root.

What Are The Benefits of Root Canal Therapy?

Root Canal Therapy will result in the removal of the infection and pain from the affected area. It is a treatment that allows the patient to retain their tooth.

What Are The Downsides of Root Canal Therapy?

Root Canal Therapy tends to require longer appointments. We schedule 90 minutes for teeth with 1 or 2 canals and 120 minutes for teeth with 3 or more canals. Root canal therapy involves a biological system, so success is not guaranteed. Studies show that success rates are approximately 90%. Teeth treated with root canal therapy may also require further treatment in the future.

What Can I Expect From The Treated Area?

Discomfort is normal after Root Canal Therapy for a few days. There should not be any swelling in the area. If the discomfort is increasing or not going away, or if any swelling is present, call our office to arrange an appointment. After a couple of weeks, you should be able to function on the tooth normally. The tooth will feel different than other teeth as there is no longer a nerve or blood supply serving that tooth. You will still need to brush and floss the tooth as normal to prevent decay and reinfection of the tooth. It takes approximately one year for a root canal-treated tooth to heal completely.

What Other Procedures Will Be Needed?

After Root Canal Therapy a full coverage restoration will be needed. That is a restoration that covers the entirety of the biting surface. The restorations can be made from resin (filling material), gold or porcelain, with each having a different longevity. Regular dental hygiene visits will also be required as well as regular dental visits to have that tooth examined to ensure the tooth does not become reinfected.

What Other Procedures Might Be Needed?

Sometimes teeth treated with Root Canal Therapy can become re-infected. This is a rare occurrence and may require a referral to a specialist. Teeth that are heavily decayed or broken may require additional treatments, such as a carbon fibre reinforcing post to be placed in the root of the tooth or an additional filling to provide support to the full coverage restoration. Gingival treatments may also be needed to trim back or treat the gums if the tooth is decayed or broken below the gumline.

What is A Dental Extraction?

An extraction involves removing a tooth. It is accomplished by pushing the tooth back and forth with specialized equipment. This increases the space in the bone and allows the tooth to be removed. In some instances, the gums need to be opened and/or bone around the tooth needs to be removed in order to gain access to the roots of the tooth.

What Are The Benefits of a Dental Extraction?

An extraction will result in the removal of pain and the removal of the source of infection.

What Are The Downsides of a Dental Extraction?

A dental extraction results in a tooth missing from your bite. This results in a loss of function, as it will be harder to chew and grind food in the affected area. It can also lead to a shift in the bite due to teeth tipping or drifting into the unoccupied space. The removal of a tooth also leads to bone loss in the surrounding areas.

What Can I Expect From The Treated Area?

Some discomfort and swelling are expected for the first few days after an extraction. If the pain is getting worse after the 3rd day, don’t hesitate to get in touch with our office for an appointment. After about a week the area should be covered over by the gums, but the bone underneath will continue to heal over the next year.

What Other Procedures Will Be Needed?

If a tooth is being removed and replaced, a bone graft is highly recommended. Replacing a tooth with either an implant, bridge or denture requires solid tissues to build upon and a bone graft allows that tissue to form in an extracted tooth socket.

What Other Procedures Might Be Needed?

When a tooth is removed, it leaves a hole in the patient’s jaw as well as their bite. Procedures such as bone grafts to build up the bone or alveoplasty to reshape the bone may be required. In the event of an infection, dry socket treatment and/or antibiotics may be necessary. Sometimes small fragments of bone and/or teeth remain in the gums and are pushed to the surface over time. An appointment may be required to remove these fragments. In order to restore function to the affected area, an implant, bridge or denture may be required to replace the missing tooth.

No Treatment

What does no treatment mean? It means just that, to leave the area alone and hope that the pain goes away. This may be done in combination with antibiotics or home remedies.

What Are The Benefits of No Treatment?

There is little to no cost to not treating the area in the short term. However, this option may turn out to be more costly in the long term.

What Are The Downsides of No Treatment?

The pain and the infection remain in the roots of the tooth. The infection can also spread through the bone to adjacent teeth and into the surrounding tissues.

What Can I Expect From The Untreated Area?

The pain and swelling will remain. It may come and go with time, but the destruction of the bone, teeth and gums will continue. It will also influence your overall health as your body spends its energy fighting this persistent infection.

What Other Procedures Will Be Needed?

Root Canal Therapy or extraction will eventually be needed. The infection will remain until it has been dealt with in one of these two ways.

What Other Procedures Might Be Needed?

If the infection spreads, root canal therapy or extractions may be required on adjacent teeth. Gum treatments may also be required to repair damaged gum tissues. A spreading infection may need to be referred to various specialists to get under control and repair the damage that was done. If the infection spreads to vital tissues that may influence your sight, airway or digestion, a visit to a local emergency room may be required.