Tooth Decay Treatment – What Are Your Options?

This article will give you a summary on the topic of tooth decay treatment. You will find that the work needed will depend to a large extent on how bad the damage is! The sooner any decay is found, the easier the treatment will generally be.

The first step in the treatment is the dentist finding (diagnosing) any cavities, so this is also discussed.

Prevention of is much more desirable than any dental work, so do check out the notes on the previous page about cavity prevention at home. Get to know the causes of any damage.


Do You Know if You Have Any Cavities?

"Tooth decayed sitting on a mirror"

Severe tooth decay treatment – Get to your dentist before things get this bad!

A decayed tooth may give no problems until the ‘rot’ is very deep. You can have no way of knowing if you have a cavity until (a) it has spread deep and the tooth gets sore or cracks or (b) your dentist finds it before it gets to this more harmful depth.  Which sounds better, (a) or (b)?!

This is why it is important to attend for regular check-ups, so the dentist can investigate by:

  • Looking for visual signs of damage.
  • Probing under fillings and crowns.
  • Using special dyes which will show up areas of caries.
  • X-rays – taken on a routine basis to help detect damage before it is visible to the dentist. The interval between x-rays being taken will vary according to your risk of dental disease.

If spotted early, treatment usually is much easier and cheaper than for deep cavities.

Read more on tooth decay symptoms here.


Treatment of Cavities – Specific Examples

"an image of dental drilling"

How far in any cavity has spread will determine if any treatment is necessary, as well as it’s type.  The following points give a summary of what procedures might be needed as a cavity gets larger.

  1. If found early enough, damage can be reversible (i.e. it goes away itself) without treatment.  This is only the case when the it is small and still within the enamel (the outside shell of the tooth).  Preventive measures alone including use of fluoride may help reverse the disease, i.e. allow the enamel to ‘re-mineralize’.
  2. Disease that has spread through into dentine (the softer inner part of the tooth) will need treatment. This will involve a dental filling.  The earlier the cavity is treated, the smaller and easier any filling will be.  There are a variety of materials that are used. The different materials, their advantages, how fillings are placed and much more is covered in our fillings section.
  3. When a tooth is extensively decayed a filling may not be enough to repair the damage.  It may need an inlay, an inlay or crown to restore it.
  4. If the disease continues unchecked, it will reach the pulp – where the nerve lies.  When it gets near the nerve, this is usually when you might feel toothache.  When the nerve (pulp) is damaged, you will root canal treatment before a filling or crown.
  5. If decay progresses unchecked, the tooth may eventually rot away to the root and will need extracted. Dental implants, bridgework or a denture will be the next step!


So if a cavity is left untreated, it will continue until it eventually destroys the tooth. It can take months or years to spread to this extent. All cavities start out small! Get them sorted before they do all that damage!



Fillings: The Most Common Cavity Treatment

Most fillings are made from dental amalgam or composite.

Amalgam fillings are silver coloured fillings that are made from a mixture of metals.  Composites are a type of plastic and are the same color as teeth.

Dental drills used for filling teeth

Other possible materials include glass ionomer, ceramics and gold.

Different fillings have different uses, advantages and disadvantages.  You will find lots more advice in this section on fillings.


“Should decay in baby teeth be treated?”

The answer to this common question is yes – decay in infants should be treated (if it can be) as baby teeth are very important. It may be thought that because they are not ‘adult’ teeth or ‘permanent’ that they are not important.

Baby teeth are important for the following reasons:

  • To maintain room for the adult teeth and reduce the need for orthodontic work later on
  • To help toddlers and children eat a full range of healthy foods
  • For speech development.

There is much more information and advice on the importance of baby teeth care in the section on dental health for kids.



A key message on this page is: if decay is not found and treated, it will continue until it eventually destroys the tooth. This is very important if you want to have healthy teeth. The disease must be found early and the only way to do this is to attend your dentist for regular check-ups.

"Image of a dental x-ray with tooth decay"

Dental x-ray showing gross damage in a molar

If you do have any work done, for example a filling is placed, you must continue to look after your teeth.  A filled tooth is not ‘fixed’ in that it can always rot again if you are not careful with your oral hygiene and your diet.

If you have any decayed teeth, filled or not, you are at higher risk of developing decay elsewhere in the mouth. This can be explained by the following reasons:

  • The other teeth are exposed to the same food and drinks.
  • They will have a similar level of plaque build-up.
  • As caries is caused by (and full of) bacteria, if you have cavities present, there will be more bacteria in your mouth.
  • Even very good fillings can have microscopic gaps under them.  These gaps can allow plaque to build up if your oral hygiene is not good enough.
  • Fillings can break down over time.  This can result in gaps and cracks where plaque and food materials can build up.  This can lead to ‘secondary decay’, i.e. around a filling, crown etc.


Therefore if you have had a cavity, with or without tooth decay treatment, the preventive guidelines outlined on the previous page become increasingly important.

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