‘But Doc, It Doesn’t Hurt Yet!’

The consequences of delaying dental treatment

By Antonio Calascibetta, DDS (‘Dr. C’)

Dr. Antonio Calascibetta
Dr. Antonio Calascibetta

Your general dentist has just done an exam on you, and you’re told that you have a cavity and an uncovery of unerupted teeth is required. You’re shocked! It doesn’t bother you, so what gives?

Bacteria that sit on teeth release acid as a waste product when breaking down sugars. As the acid leaks and demineralizes the outside of the tooth (the enamel), a cavity is formed. Cavities in this stage rarely need to be treated with fillings — using fluoridated toothpaste and drinking fluoridated tap water can keep these cavities at the same size for years, even decades. They don’t cause pain, because the enamel has no nerve tissue.

However, once the decay reaches the softer, inner portion of the tooth (the dentin), the cavity must be managed with a filling, as it will never repair itself as enamel can. It’s at this point where we may get pushback from patients as “it doesn’t hurt yet.” Therein lies the danger. The acid from the bacteria spreads much more quickly in the dentin, and as it approaches the nerve (the pulp), it can become quite bothersome. When the cavity does inevitably cause you the dreaded toothache, it is generally too little, too late. Frequently, your only two options are a root canal or pulling the tooth.

Early management of these smaller cavities will prevent more costly and lengthy visits, and more importantly, preserve your smile. If you have missing teeth, you may consider getting dental bridges to restore your full smile.

If a dentist recommends a large treatment plan to you because you have cavities, yet none of them are hurting, it never hurts to ask for a second opinion — this is something I recommend to all of my patients if they have doubts. Don’t wait too long, though! Nobody likes to sit through a root canal.

Dr. Antonio Calascibetta’s practice is Celestial Dental located on W. Henrietta Road. For more information, visit  www.celestialdental.com or call 585-360-0202.