What it May Take to Save a Tooth Ravaged by Disease


Although dental implants are the nearest artificial teeth we have to the real thing, we should still consider saving a tooth first before replacing it. Real teeth by nature are better for overall dental health and function better than even a life-like implant.

How we save such a tooth will depend largely on what ails it. In most cases, that will be one of two dental diseases: tooth decay or periodontal (gum) disease.

Both diseases begin with dental plaque, a thin biofilm of bacteria and food materials that remain on tooth surfaces. The greater the plaque (often because of poor hygiene), the more these bacteria multiply and, pertaining to tooth decay, the more acid they produce. High acid levels soften and erode tooth enamel, which opens the door to decay.

The degree of decay within a tooth determines the manner of treatment. If it's limited to the enamel and upper dentin layers, we may only need to remove the decayed structure and fill the cavity. Decay reaching the pulp and root canals, however, often requires a more invasive procedure known as root canal therapy.

During a root canal, we drill into the tooth's interior to clear out diseased tissue. We next fill the now empty pulp chamber and root canals to prevent future infection. While general dentists can perform basic root canals, more complex cases often require the services of an endodontist, an interior tooth specialist with the necessary expertise and equipment for just such situations.

Bacteria also causes gum disease, albeit by directly infecting the gum tissues. The disease can quickly spread deeper into the gums, ultimately affecting the roots and underlying bone, and putting the tooth in peril. More teeth, in fact, are lost to gum disease than to tooth decay.

To stop the disease, we must remove any and all dental plaque and tartar (calcified plaque), which feeds the infection. The most effective means for doing this is with hand instruments called scalers and ultrasonic equipment. We may also need to surgically access deeper deposits around the roots to successfully remove them.

As you can see, treating either of these destructive diseases ranges from simple to complex and invasive. But even extensive measures are well worth it for both your tooth and your future dental health.

If you would like more information on dental treatment options, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Save a Tooth or Get an Implant?