Dental caries is an infectious microbiologic disease which causes dissolution and destruction of calcified tissues of tooth structure. Initially patient may not feel anything with tooth decay but when decay reaches the dentin portion of tooth, then patient will experience sensitivity to hot and cold food stuffs and when decay reaches the pulp portion of the tooth, then severe pain occurs. When only a small portion of tooth is demineralized, then tooth can be remineralized with fluoride application or fluoride rinses. When decay reaches dentin, then restoration or dental crown is given for the rotten tooth. When pulp is also involved in tooth decay, then root canal treatment is done for the decayed tooth. RCT followed by post and core procedure and dental crown is given in case of badly mutilated tooth structure.
Treatment of cavities in teeth depends on extent of tooth decay which is present.
Fluoride Application or Fluoride Rinses
If only a small portion of tooth is demineralized, then by fluoride application or fluoride rinses remineralization can be done. More fluoride is present in professional fluoride treatment than over the counter mouth washes and tooth pastes. In case of initial tooth decay, fluoride treatment may be able to restore the enamel of the tooth. In case of professional fluoride application, fluoride may be in form of liquid solution, gel, foam or varnish which is applied on teeth or is placed in trays which can be fitted over teeth. Professional fluoride application takes few minutes. Periodic fluoride treatment may also be required.
When decay has progressed beyond early enamel erosion state, then filling is done for decayed tooth. When dissolution and destruction of calcified tooth structures takes place, then dental filling is done to replace the decayed portion of the tooth. Dentist will remove the decayed and damaged tooth structure with a drill and will fill the missing tooth structure with filling material. Resin composite, silver amalgam, glass ionomer cement filling can be given to the patient. Composites are tooth colored, esthetic filling material which is available for tooth restoration. Silver amalgam restorations are widely used in different types or sizes of cavities and have high strength. Silver amalgam fillings are mainly given for back teeth and lasts for many years.
Dental Amalgam Restoration Dental Composite Restoration
Filling materials are safe. Concerns have been raised over safety of silver amalgam dental fillings. ADA, FDA and other public health agencies still support dental amalgam safety.
If much of loss of tooth structure has taken place, then indirect restorations are given to the patient. More than 1 visit is required to restore the tooth with indirect restoration. Tooth preparation and impression is taken in the first appointment. Impression is sent to the lab. In the second appointment, material is placed in prepared tooth. These include veneers, inlays, onlays, crowns and bridges fabricated with gold, base metal alloys, and composites.
If much of tooth structure is lost, then large dental filling in tooth will make tooth liable to fracture and breakage. In case of large dental cavity, dental crown is given which will reinforce the weakened tooth structure. Only Dental filling if done in case of tooth with large dental caries will just occupy the space of missing tooth structure but will not enhance the strength of the tooth.
Dental crown is a restoration which covers the outer surface of tooth like cap and is cemented to the tooth structure with help of dental cement. There are 3 types of dental crowns, Porcelain dental crowns, Porcelain fused to metal (PFM) dental crowns and metallic dental crowns. For front teeth, all porcelain dental crowns or PFM dental crowns are given and for back teeth, PFM dental crowns or metallic dental crowns can be given.
Root Canal Treatment
In case of untreated tooth decay, when infection reaches the pulp portion of tooth, root canal treatment is done for the tooth. In case of root canal treatment, infectious, necrotic portion of the tooth is removed and is replaced with filling material. Essence of root canal treatment lies in efficiency of root canal procedure to stop the infection causing bacteria from seeping through the infected root canal. After root canal treatment, tooth becomes brittle. To provide strength to root canal treated tooth and to hide the discoloration which may occur after root canal treatment, dental crown is given on the tooth.
Post and Core Restoration
In case of extensively decayed or fractured tooth structure, root canal treatment followed by post and core and dental crown procedure is done. Post is a pin like structure which is cemented in the root portion of the tooth. Over the post, core build up is done with suitable restorative material. Dental crown is given after core build up to completely restore the tooth structure.
Crown cemented over core
If tooth is so severely decayed that it can’t be restored, then tooth extraction is done. After tooth extraction, the missing tooth can be replaced with dental implants or dental bridge. Dental implants are best option for replacement of missing teeth. If missing tooth is not replaced, then it can lead to misalignment of other teeth, supraerution of tooth of opposite dental arch and can lead to various periodontal complications.
Cost of Treatment of Decayed Teeth
Cost to treat decayed tooth depends on extent of tooth decay which is present. If decay has reached the dentin, then tooth can be restored with composite restoration or amalgam restorations. Cost of dental filling further varies on the basis of number of surfaces which are involved in tooth decay. Silver amalgam filling for permanent teeth costs around $100-$200 per tooth and cost of permanent composite fillings is $100-$300 per tooth depending on the type of tooth structure and number of surfaces which are involved in tooth decay.
If much of tooth structure is lost, then dental crown is given. Cost of dental crown is $600-$1100 per tooth depending on type of dental crown you opt for. Cost of metallic dental crown is $600-$1050 depending on amount of precious metal which is present within dental crown. Cost of PFM dental crown is $650-$1000 and cost of all porcelain dental crowns is $800-$1750.
If nerve of the tooth is also involved, then root canal treatment is done. Cost of front tooth root canal treatment is $360-$700 per tooth and cost of root canal treatment of bicuspids is $600-$900 per tooth. Cost of root canal treatment of molars is $800-$1300.
If tooth is badly mutilated, then post and core procedure is done after root canal treatment to provide stability to the tooth. Cost of cast post and core is around $300-$400.
If tooth is so severely decayed that it can’t be saved, then extraction of tooth is done. Cost of simple tooth extraction is $100-$150. If whole of the crown is decayed and has rotten and only the roots of the tooth are left, then surgical tooth extraction may also be required. Cost of surgical tooth extraction is $150-$200 per tooth. Missing tooth can be replaced with dental implants or dental bridge after tooth extraction.