Dental caries - Treating tooth decay

The treatment for tooth decay largely depends on how advanced the problem is.

If your decay is in the early stages, your dentist may apply a fluoride varnish to the area to help stop further decay.

If decay has worn away your enamel (the hard outer coating of a tooth) and led to a cavity, your dentist will remove the soft decay and replace the hole in your tooth with a filling. If the nerve in the middle of your tooth is damaged, you may need root canal treatment, which removes the nerve and restores the tooth with a filling or crown.

If the tooth is so badly damaged it cannot be restored, it may need to be removed.

Fluoride

Fluoride is probably the most effective treatment available for preventing and limiting the spread of tooth decay. It is a naturally occurring mineral found in foods and drinks, such as fish and tea, but it can also be synthesised (manufactured).

Synthetic fluoride is used in toothpaste, from which most people get their fluoride, and small amounts of it are added to the water supply in some areas of the country.

Fluoride protects teeth by strengthening the enamel, making teeth more resistant to the acids that can cause tooth decay. It reduces the ability of plaque bacteria to produce acid, and enhances the repair (remineralisation) of enamel.

If your cavity is in its early stages, your dentist may be able to prevent further decay by applying a concentrated fluoride gel, varnish or paste to any affected teeth.

Fillings and crowns

If the decay to one of your teeth is more extensive, it may be necessary to repair the damage with a filling or crown.

A filling replaces your missing enamel. There are many different filling materials available, including amalgam (silver coloured), composite (tooth coloured) and glass ionomer (tooth coloured).

Inlays and onlays can also be used to fill teeth. They specifically fill the size and shape of your cavity, and are fixed in place with dental cement. Inlays and onlays are usually made from gold, as it is the most long-lasting and hard-wearing filling material.

Crowns are used to treat extensively damaged teeth. The decayed section of the tooth is drilled away and the crown is placed over the remaining section. Crowns are made of metal, porcelain, or a combination of the two.

Root canal treatment

If tooth decay has spread to the pulp (the soft centre of the tooth), the pulp may have to be removed and replaced with an artificial pulp that will keep the tooth in place. This is known as root canal treatment.

Root canal therapy has had a reputation of being painful, but improved dental techniques mean it is now relatively painless.

Read more about how root canal treatment is performed.

Tooth extraction

In serious cases of tooth decay, the tooth may be removed to prevent the spread of infection.

Losing certain teeth can affect the shape and function of surrounding teeth, so the dentist may have to replace the tooth with a partial denture, bridge or implant.