Your dentist told you you have a cavity in your tooth.  And that you need to have a filling done to fix it.  So now what?  Do you have to have it fixed?  Will it go away?  What will happen if you don’t fix it?  Let’s discuss those questions a bit more since they are common and logical questions many patients have.

Kid's Cavity

Cavity on a lower right primary molar in a child.

Do you have to have it fixed?

The short answer?  No.  No one is going to make you do anything.  All patients have the right to make their own decisions about their oral health.  Your dentists, hygienists and dental assistants are here to educate you on your diagnosis as well as your options.  We can answer questions about risks and benefits of your options and help you make an educated decision on what you would like to do, but ultimately, the decision is yours.

Will it go away?  What will happen if you don’t fix it?

Also no.  Unfortunately, once the bacteria that cause cavities have created a hole in your tooth (the cavity), the only way to fix that hole is to have a filling done.  If a filling is not done, the bacteria will continue to grow the cavity and it will get larger.  As the cavity gets larger, it breaks down the structure of your tooth and can move closer to the nerve of the tooth.  

The structural breakdown of the tooth puts you at greater risk of the tooth breaking on you.  When a tooth breaks, there are a couple scenarios that you could be met with.  Often times, the break just leads to you needing a larger filling than originally thought.  Sometimes it leads to a structural issue that requires a crown to repair it.  In rare but unfortunate circumstances though, the fracture can go under the gums and bone and require the tooth to be extracted.

If the cavity moves towards the nerve of your tooth, the bacteria causing the cavity can get into the nerve of your tooth and cause an infection.  This infection causes a toothache.  Once the tooth is infected, there are only two options to heal the infection.  You can have a root canal done to remove the nerve of the tooth and the infection, or you can have the tooth extracted.  Most teeth that need root canals will also need a crown placed afterwards.

root canal

Root canaled and crowned tooth on upper left.

If the cavity grows too close to the bone, then the tooth may need to be extracted.  There is a limit as to how close a filling can be placed to the bone.  If the cavity is too close to the bone, any filling material placed there will cause the body to react to the filling material leading to the eventual downfall of the tooth so it would be recommended to extract it instead.

This is why we recommend fixing cavities with fillings.  The earlier we can repair a tooth, the less likely it is to have any of these unfortunate outcomes, especially an extraction.  By finding cavities when they are small and repairing them early, we can help you keep your teeth.  If you have questions about your cavity, make sure you ask your oral health team about what they would recommend to fix it.  After all, you chose them as your oral health care providers because you trust their education and opinions.  Use their knowledge to help you make an informed and educated decision about your oral health.

Perfect Smile