Treatment for tooth decay varies depending on the nature and extent of the damage a patient experiences. If acid has not yet eroded through the enamel (a condition typically indicated to dentists by white spots on the tooth, but no holes), the tooth may repair itself naturally with the use of fluoride treatments provided in a dental office or at home.

However, once a cavity has penetrated the enamel, it cannot be reversed. Instead, the goal is to arrest further progression of the cavity. Left untreated, a cavity typically continues to deepen and worsen, although the length of time a cavity takes to progress varies.

Dentists typically treat cavities by using a dental drill to remove the decayed material and fill the hole with a material such as dental amalgam (made from silver alloyed with copper or other materials), composite resin (made of a tooth-colored substance) or porcelain (also made of a tooth-colored substance). Gold inlay is sometimes used when greater strength is needed.

If the damage from a cavity is extensive, the dentist may have to cover the filling with an artificial crown. This helps minimize the risk of a weakened tooth cracking. Crowns typically are made of gold, porcelain or porcelain fused to metal.

When damage extends into the interior of the tooth, a root canal procedure may be needed to remove the tooth’s pulp (including the nerve and blood vessel tissue) and replace it with a sealing material. A dental professional called an endodontist performs this procedure. Once the root canal is finished, the tooth is covered with an artificial crown.

Before any of these procedures are performed, the patient receives a local anesthetic or nitrous oxide (laughing gas) provided by a mask placed over the patient’s mouth and nose. In some cases, a general anesthetic will be used so that the patient is not conscious during the procedure. Treatment is usually less extensive, less painful and less expensive when the cavity is detected early.