Deep Dental Decay: Filling, Root Canal, or Extraction?

By the time you’re suffering from a toothache, dental decay has progressed, edging ever closer to the sensitive nerves in your tooth's center.

Repair options become more limited as the cavity erodes more of your tooth. The sooner you seek treatment from Maria Victoria Sebastian, DDS, and our skilled team at Dentistry With a Smile in Livingston, New Jersey, the better your chances are that we can repair the decay with a simple filling.

Even if your deep decay demands more than a filling, whether a root canal or extraction, we combine our expertise with state-of-the-art technology to ensure your treatment is painless and restores your beautiful smile.

From a cavity to deep dental decay

Cavities begin when bacteria erode the hard enamel covering your tooth. After bacteria breach the enamel, decay takes hold, and you have a cavity. Then, the damage gradually spreads through the dentin inside your tooth.

Dentin, your tooth’s middle layer between the enamel and the delicate pulp in the center, is made of bone but softer than enamel. This means the cavity can enlarge faster than it took to get through the enamel.

Though a cavity is considered “deep” when it reaches the dentin, we typically diagnose a deep cavity when the decay is extensive, often with significant enamel loss, and reaches the inner one-third of the dentin (close to the pulp).

Since the pulp contains nerves, your pain increases as your cavity gets deeper.

Treating deep decay with a filling

We treat cavities with fillings whenever possible. Several variables influence when we recommend a filling.

We consider the size of your cavity, its location, the extent of damage to your tooth, and your tooth’s overall health. This type of restoration is only possible when enough healthy tooth remains to support and retain a filling.

We also can’t use a filling if your tooth is infected or the decay reaches the pulp. Pulp involvement means we must consider a root canal or tooth extraction.

Root canal vs. extraction

Our top priority is saving your tooth. Whenever possible, we do a root canal instead of pulling your tooth (extraction) because a root canal eliminates the infection and decay while preserving your natural tooth. You need an extraction when your tooth is damaged beyond repair.

Here’s what you need to know about both procedures:

Root canal

Before every procedure, whether a filling, root canal, or extraction, we explain your anesthesia and sedation options and provide the treatment you need to stay comfortable and pain-free.

During a root canal, we create a tiny hole in the back of your tooth and insert a specialized tool that cleans the pulp and the two narrow openings (canals) running through your tooth roots.

After removing all the decay, infection, and tissue, we disinfect the spaces. Then, we fill them with dental putty to preserve your tooth’s structure.

For the final step, we fully restore your tooth’s strength, function, and appearance by covering it with a ceramic crown. The technology provided by our in-house E4D Dentist™ system allows us to design and produce exceptional same-day crowns.

Tooth extraction

Your tooth extraction procedure depends on how much of your tooth is above your gumline. If there’s enough healthy tooth, we gently loosen it and pull it out. If your tooth is severely decayed or very little remains above your gum, we cut into your gum to remove it.

After an extraction, the tissues need to heal before we restore your smile by replacing your tooth. Most people get a dental implant, but the best choice for you depends on the health of your jawbone and personal preferences.

Seek help at the first sign of pain

Routine checkups protect your dental health and help you avoid needing more than a filling. But if a toothache begins, don’t wait to seek help. Putting off dental care gives decay time to worsen.

Call our office or book an appointment online today to get relief from your pain and save your tooth.