Cavities and tooth decay

Diagnosis

Your dentist usually can detect tooth decay by:

• Asking about tooth pain and sensitivity.
• Looking around inside your mouth and at your teeth.
• Probing your teeth with dental instruments to check for soft areas.
• Looking at dental X-rays, which can show where cavities and decay are.

Your dentist also can tell you which of the three types of cavities you have: smooth surface, pit and fissure, or root.

Treatment

Regular checkups can find cavities and other dental issues before they lead to more-serious problems. The sooner you seek care, the better your chances of reversing the earliest stages of tooth decay and stopping it from getting worse. If a cavity is treated before it starts causing pain, you probably won't need a lot of treatment.

Treatment of cavities depends on how serious they are and your 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. Fillings are made of various materials, such as tooth-colored composite resin or porcelain, or dental amalgam that is a mixture of several materials.
• Crowns. If you have a lot of decay or weakened teeth, you may need a crown — a custom-fitted covering that replaces your tooth's entire natural crown. The crown helps protect the soundness of the tooth and lowers the risk of fracture. Your dentist drills away 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, called the 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. Medicine 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 seriously 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 having 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.

Preparing for an appointment

Before your appointment, make a list of:

• All medicines, vitamins, herbal remedies or other supplements you're taking, and doses.
• Any allergies to medicines or bad reactions you've had to local anesthetics.
• Bring in any mouthguards or oral appliances that you wear.
• 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 medicines 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 a pain reliever available without a prescription if your healthcare professional has said it's OK for you.
• Use a numbing medicine available without a prescription that is 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.
• Stay away from foods or beverages that are hot, cold or sweet enough to cause pain.