Treating Deep Dental Decay: Will I Need a Large Filling, a Root Canal, or a Tooth Extraction?

Like many other health conditions, tooth decay has varying degrees, from minor mineral loss to pulp damage and ultimately, tooth loss. Deep dental decay develops when problems break through outer tooth enamel and internal dentin tissue, potentially compromising the pulp of your tooth in the root canal. 

At New York Dental Health, we’re ready to help you no matter your level of decay. Deep decay typically requires more involved treatment than a simple cavity, so let’s look at what you may be facing with more advanced tooth deterioration. 

The five stages of decay

Decay starts with demineralization of your teeth, which can present as white spots in the enamel surface of your teeth. Tooth enamel consists largely of minerals, like calcium carbonate, calcium fluoride, and calcium phosphate, the most abundant mineral. 

Demineralization leads to enamel decay, the second stage. White spots darken to brown and small holes, called cavities, begin to form. 

Below tooth enamel is dentin, a softer tissue. Tooth decay accelerates when it reaches the dentin layer, since the soft dentin puts up less resistance. Temperature sensitivity is common when decay reaches the dentin layer. 

The fourth stage of decay involves the tooth pulp, the nerves and blood vessels that normally fill the root canal. Decay causes inflammation of this tissue, leading to nerve pressure and pain. 

The final stage of tooth decay results in an abscess, as bacteria invade and infect pulp tissue. An abscess is a pus-filled pocket near the base of your tooth and tends to cause severe pain that can radiate into the jaw. 

Will I need a large filling, a root canal, or a tooth extraction for deep decay?

Tooth extraction is always a last resort. If there’s a way to preserve a natural tooth, we recommend those options rather than extraction. 

Adult teeth can survive without the pulp tissue, so if the root canal becomes compromised or an abscess forms, root canal therapy is your best option. We remove the pulp, clean and fill the canal, and seal the tooth.  

If the root canal is intact, a large filling may be enough to repair decay damage. In the case of large fillings and root canal therapy, we may recommend that you enclose the tooth in a dental crown to add strength and avoid further tooth damage. 

Should decay result in an extraction, ask us about dental implants, the best way to replace a lost tooth. Unlike dentures, implants have both a crown and a root, more closely resembling a natural tooth. 

Don’t let tooth decay get the upper hand. Contact New York Dental Health at the nearest of our seven locations. Schedule an appointment online or by phone today.