Cavities or Decay

Dental fillings are the answer for most cavities. The area is numbed, the decayed part of the tooth is cleaned out, and the space is sealed with composite, a tooth-colored material matched to your enamel and placed in thin layers, each hardened with a light. Dr. Bhoompalli shapes the filling to the tooth and checks your bite before you leave. A filling is done in a single visit, and several cavities in the same area can often be treated together. A composite filling typically lasts five to seven years.

A filling needs enough healthy tooth around it to hold. When decay has taken too much of the tooth, or a filling would be bigger than the tooth around it, dental crowns take over. A crown is a custom cap that covers the whole visible part of the tooth and holds what is left together, so the tooth can take a full bite again instead of splitting. It takes two visits, with a temporary crown in between. Porcelain and ceramic match teeth that show; metal is strongest for molars. Dr. Bhoompalli takes a conservative approach: if a filling will keep the tooth sound, that is what she recommends.

When decay reaches the soft core of nerve and blood vessels inside the tooth, the pulp becomes inflamed and then infected. That is the throbbing toothache, the sensitivity to heat that lingers, the swelling in the gum. At that point a filling or a crown alone cannot fix it, because the infection is inside the tooth. Root canal therapy comes first: the infected pulp is removed, the canals are cleaned and sealed, and the pain stops because its cause is gone. A back tooth is then finished with a crown. You are fully numb before anything begins, and a tooth in pain is seen as an emergency.