Portrait of a beautiful woman at the dentist getting her teeth checked - oral health concepts

How are Cavities Treated?

In most cases, patients are not able to catch cavities in the early stages because they come when they feel pain and sensitivity or cannot tolerate the pain in their teeth – which means that the cavity has progressed and grown in the tooth to a certain degree. Thus, it would lead one to question, how are cavities treated?

Do Cavities Heal on their own?

The simple answer is no. They do not go away on their own! Tooth decay is permanent damage that is done to the teeth and need to be addressed as soon as possible so that it involves less treatment time, is less expensive, and less invasive treatment for the patient. Tooth decay and pain just get worse as time passes so it is imperative for patients to get regular checks for early detection.

There are some patients that feel even small amounts of pain, but some just tolerate and endure the pain thinking that it will go away on its own, but this is never the case! The pain will just keep getting worse! The best thing to do is to go in for a checkup to see if it is a cavity or other dental problem that needs to be addressed!

What are the methods of treatment?

The dentist will start with a scan / x-ray of the tooth and an examination of the affected area. With the combination of the two, the dentist will be able to determine and diagnose what stage of tooth decay the patient is at and inform the patient of the recommended course of treatment. If the patient agrees to the course of treatment, they can proceed.

For the first stage of tooth decay, to help treat the demineralization and damage in the enamel, fluoride treatment can be done to help the tooth. The treatment will help strengthen the outer layer of the tooth (the enamel). However, it may not do help with the white spot discoloration.  

The second stage of tooth decay which is at the enamel, the outer layer of the tooth, the tooth decay causes holes in the tooth (also known as cavities). The cavities look like dark spots on the tooth from the discoloration that is also caused during this stage. The treatment for this stage of tooth decay is to get fillings. Amalgam fillings are discouraged as they contain metal in it; at the Oaks Dental Clinic, amalgam fillings are not done, only resin which has the similar color to normal teeth.

The third stage of tooth decay is at the dentin layer which is the layer found beneath the enamel. Depending on how early the detection is, the patient may receive a filling or they may need to go further and get a partial crown (an inlay or onlay) depending on the size of the cavity. In more serious cases where it is more advanced and is close or near the pulp, the dentist may recommend getting a root canal.

The fourth stage of tooth decay is at level of the pulp – the bacteria and decay has reached the innermost layer of the tooth. The treatment to pulp damage is to get a root canal and a crown. A zirconia crown is recommended for teeth that has had a root canal because the tooth is weakened with a root canal and the zirconia crown is the strongest which will allow it to better protect the tooth. Moreover, zirconia crowns are especially recommended if the tooth with the root canal is a front tooth because teeth that have root canals turn dark and the darkness can be seen through crowns made with other materials than zirconia as they tend to be more translucent.

The fifth stage of tooth decay is an infection called an abscess. In this case, it will again depend on how far the infection has progressed. If the tooth can be saved, the dentist will perform a root canal and put a crown on it. However, if the infection has progressed to much, the dentist may recommend extraction.

Prevention is Key!

Cavities can be prevented with good oral hygiene routine, regular cleanings and checkups with the dentist. Cleanings (also known as scaling) are needed to prevent the build up of plaque which play a large part in creating the acids that cause tooth decay! Checkups are great for early detection! Most importantly, regular brushing and flossing help prevent the buildup of plaque which is an essential thing to do after each meal!

Human tooth with caries, hole and tools. Dental searching concept. Teeth or dentures. 3d illustration

Stages of Cavities

There are different stages to cavities, so it is best to catch them as early as possible to save money and time. As you may know, the whole process of cavities starts with plaque on the teeth that naturally occurs; it is the stuff that we need to brush away and remove through good oral hygienic practices. For more information, please check the previous post (LINK HERE).

Stages of Tooth decay

In general, there are 5 stages to tooth decay. The first stages start with demineralization of the tooth. The tooth is protected by the enamel which is known to be the hardest tissue of the body. Due to the plaque and the bacteria making acids and exposure to these acids leads to the demineralization process which is the loss of minerals in the enamel. As this begins, white spots occur on the teeth which signifies the loss of minerals in the area of the decay.

The second stage is enamel decay which is what patients commonly recognize as cavities – the brownish spots on a tooth. Once the tooth goes beyond the demineralization process, the enamel breaks down causing further discoloration in the tooth. This is the stage where the tiny holes appear, and the cavities need to be treated with a filling by the dentist.

The third stage is the decay in dentin. Dentin is found under the layer of enamel found under our teeth. It is softer tissue so when the acid from the plaque hits this level, it is more sensitive, causing pain and sensitivity for the patient. This stage of tooth decay is where the patient would have sensitivity to hot and cold foods. As the tissue is more sensitive, cavities or tooth decay, progresses much faster than it did when it was just at the enamel.

The fourth stage of tooth decay is when the pulp of the teeth is damaged. The pulp area of the tooth is the innermost area and contains the nerves and blood supply. When the decay reaches to the pulp of the tooth, the area becomes infected and irritated, causing inflammation. As the teeth itself is like a hard shell that doesn’t expand, pressure may build up on the nerves, leading to pain.

The last stage of tooth decay is infection. As the pulp contains the nerves and the bacteria affects the area, it can cause an infection called an abscess and create a pouch of pus. This last stage of tooth decay causes the most pain in people – as the pain can radiate throughout the area of the tooth – the jaw, ear, neck. In severe cases, other symptoms like fever or swelling of the lymph nodes can appear.

What are the next steps?

Depending on how far along the cavity or tooth decay has progressed, the treatment methods will differ. This also affects how invasive the treatment is, costs of treatment, and the time for treatment completion for the patient so the earlier the visit to the dentist, the better!

To start, the dentist will not only do an in-person examination of the affected teeth and gums but also suggest an x-ray of the affected tooth to see what exactly is going on and causing the discomfort in the patient. At the Oaks Dental Clinic, we take a panoramic CT scan which shows the whole mouth – all the teeth and surrounding areas in one photo! If needed, the doctor may suggest an individual, smaller x-ray be taken, but the panoramic CT scan allows the doctor to have a clear view of all the teeth and their health.

At the Oaks Dental Clinic, the doctor and English-speaking consultant (for international patients) will explain the process of events before anything begins. After the patient has their scan taken, the doctor will perform a checkup to see how far the progression has gone and the doctor will recommend the course of treatment according to the patient’s case. The patient then decides whether they agree with the recommended course of treatment or if they do not. In the event that a patient does agree, treatment will begin right away or another day may be chosen (according to the schedules of both the clinic and the patient). If the patient does not agree with the course of treatment, they are under no obligation to commence treatment – they can take some time to think about the recommendation and come in on another day if they choose.

For information on how cavities are treated, click here!

Female patient with open mouth  receiving dental inspection at dentist's office

What are cavities?

Cavities are the result of tooth decay. They are basically holes that created from the decay. As cavities, progress, pain is caused, resulting in the patient visiting a dental clinic.

What is tooth decay?

Tooth decay is damage that is arguably caused from bad oral hygiene. Proper brushing and flossing are necessary in the prevention of plaque forming on the teeth. Plaque is formed from a mix of elements found in one’s mouth – saliva, natural bacteria, acids, and food particles. Plaque that forms on the teeth damages teeth in the long run because it turns sugar into acid. This acid works to dissolve the person’s enamel of the teeth, causing holes, also known as cavities.

Do cavities go away on its own?

No. Cavities do not go away on its own, and when they are left untreated, they continue to grow in size, cavities grow bigger and bigger, eating away at not only the enamel but into the inner layers of the tooth – the dentin (the softer tissue below the enamel, and even to the roots of the tooth. As cavities grow, they may not at first cause any pain to a patient – especially when it is smaller and at the enamel layers of the tooth.

However, a patient may start to feel pain as it reaches the inner layers of the tooth. They should not be left alone – patients who feel the slightest bit of pain are encouraged to visit their dentist for a checkup to see if it is a cavity causing the pain and to get it treated as soon as possible. This is because when cavities are left untreated, they not only cause pain, but grow, which means, the hole in the tooth gets bigger and bigger – it might grow bigger and bigger from the inside so to the visible eye, the cavity might appear to be a speck; in this instance, if the person bites down on something hard, the tooth will break due to the hole on the inside.

If a tooth breaks, the dentist will do their best to save the tooth, using methods like root canals and crowns but in some cases, the damage may be too severe to save the tooth – meaning, the patient will have to have the tooth extracted.

What are cavities?

What are some signs of cavities?

If the cavity has grown, patients will experience tooth pain, other symptoms may include bad breath, soreness, swelling gums, bleeding gums, and sensitivity to hot and cold food/drinks.

How are Cavities diagnosed?

It is to spot things like cavities in the early stages that patients are recommended to visit their dentist for regular checkups. During the checkup, the dentist will look for spots on the teeth which will signify cavities as well as taking X-rays of specific teeth. At the Oaks Dental Clinic, a Panoramic CT scan (all the teeth in one photo) can be taken to show all the teeth and if specific x-rays need to be taken, it may be required as well.

How are cavities treated?

Cavities are treated using a variety of methods like fillings, inlays, onlays, and root canal with crowns. If the cavity has progressed past a certain point, the tooth cannot be saved and so the patient will need to have the tooth extracted. In this instance, the patient will need other forms of restorations like bridge or implant to fill the gap that occurs from the extraction.

Prevention is Key!

Thus, prevention is key! We can’t emphasize this enough to our patients. Cavities can be prevented with a good oral hygiene routine consisting of good brushing and flossing habits.

Patients should aim to have visit their dentists twice a year for a checkup and cleaning– even if it seems everything is fine! Cavities can exist on the enamel level where they cannot be felt. Early detection and treating them early saves money, time, and it is less invasive!

Regular cleanings (also known as scaling in some countries) are also highly recommended for patients. This procedure may also seem cumbersome, so patients often skip dental cleanings, but it is imperative for good oral health. Regardless of a good oral hygiene routine, plaque can still grow in the hard to reach areas so it is important to get regular cleanings at the dental clinic to remove them because they can continue to grow and later become cavities. Hence, taking the time to take all the preventative measures is imperative to having a healthy and happy smile.

Dentist wearing eyeglasses gloves and mask examining a patient teeth with a dental probe and a mirror in a clinic box with equipment in the background

Regular cleaning vs. Deep cleaning – What is the difference?

Regular Cleaning (Scaling)

Regular cleaning, otherwise known as scaling, is the process in which a hygienist removes a buildup of plaque and tartar from a patient’s teeth. This process is needed every 3-6 months in order to maintain healthy teeth and gums. Regular cleanings help prevent periodontal infections and inflammation and should be done every 3-6 months.

The procedure time for regular cleanings (scaling) is on average between half an hour to an hour depending on the amount of building up of plaque and tartar that the patient has. Thus, the more build up, the longer the procedure would take to complete. There is no need for anesthesia with the regular cleaning (scaling).

Common side effects after a regular cleaning (scaling) is sensitivity in the teeth, sore gums, bleeding, swollen gums and a small gap between the teeth. The small gap between the teeth that is mentioned is that patient may see a small space in the area between the teeth and gums and mistake that the hygienist did something to make a hole. This is not the case as the area was filled and blocked by plaque and tarter buildup and their removal leaves the space. Please note that not everyone gets these side effects, and some patients may experience a combination of side effects.

Regular cleaning vs. Deep cleaning – What is the difference?

Deep cleaning

Deep cleanings (sometimes called gum treatment) are a similar process to regular cleaning, but it takes a step ahead and cleans below the gum the gum line, removing buildup of plaque and tartar. Deep cleanings are not done regularly, and the patient is not able to ask for one like a regular cleaning; it is a procedure only done when there is gum inflammation or for other reasons when recommended by the doctor. The aim of the procedure is to promote healthy gums, protecting the root of the teeth.

The time it takes to do the deep cleaning differs according to the patient and their case but on average the procedure takes about one to two hours. This is also because local anesthesia is used and there is a wait time for the anesthesia to work, numbing the area. After the local anesthesia numbs the area, the doctor gets to work in cleaning, gum scraping, and scraping the plaque off the teeth.

Please note that in Korea, the laws for the usage of anesthesia and drugs are very strict so only local anesthesia can be administered to patients in normal dental clinics. If anything stronger needs to be administered like general anesthesia or being put to sleep, patient’s will have to visit the large general (university) hospitals as they are the one’s that are allowed in general to administer anesthesia stronger than local.

The common side effects for the deep cleaning procedure are some sensitivity, soreness and bleeding from the gums which is completely normal. The bleeding usually stops soon after the procedure is completed (may differ according to the patient) and the soreness goes away after a few days. During this time, it is important to maintain proper oral hygiene to ensure that the gums heal normally.

Other risks or side effects may include the possibility of fillings becoming loosened or popping out if the patient has any (the doctor can repair it later) because of the scraping process when doing the deep cleaning procedure.