When Is It Too Late For A Cavity With Pain?

If your cavity starts hurting you, it is your body's way of letting you know that you need to go see a dentist. However, the type of treatment that is required for a cavity that hurts would depend on the size of the decay. There is always some type of treatment option regardless of the size of your cavity so it is never too late. Although, you may not necessarily like the treatment option that is given to you for your cavity size.


Cavity pain should definitely not be ignored because it will not go away on its own. It definitely requires treatment and there are no home remedies which can stop it.



Table of Contents:



The size of the cavity and their treatment

It is never too late for a cavity even if it hurts because there is always a treatment option available for it. However, you may not like what needs to be done but it all depends on the size of the cavity. The size will dictate what type of treatment is required to fix it.


Small cavity

A cavity filling is usually sufficient for a small sized cavity, regardless of it it hurts or not. This type of tooth decay is as the name implies, small in size. This means that it is most likely contained within the enamel or dentin layer at most.


small cavity on chewing surface of molar
small cavity on chewing surface of molar

The most that needs to be done is to remove the tooth decay and then fill it back in with a tooth filling material. After you get that procedure completed, whatever you were feeling before whether it be pain or sensitivity should go away.


Process to fill a small cavity:

  1. Administer local anesthetic to numb the affected tooth.

  2. Excavate the decay by drilling it out.

  3. Apply conditioner, primer, and bonding agent.

  4. Fill the tooth with a composite resin.

  5. Cure the restorative material with a LED light.

  6. Adjust the occlusion to make sure the bite is even.

  7. Polish the cavity filling.



Medium sized cavity

A medium sized cavity that hurts is not hopeless because it can still be treated. Although there is a good chance that it may require more than a simple filling because a dental crown may be a better option. Whether or not it would require a crown would depend on the number of surfaces the cavity involves and whether or not there are other existing fillings on the tooth.


If it seems like the tooth is going to approach close to needing 50% of the tooth restored, you may be better off with a crown. If it is less than that, a filling may be sufficient but every situation is different and your dentist will help you make the decision.


medium sized cavity on chewing surface of molar
medium sized cavity on chewing surface of molar

Process for a dental crown:

  1. Give local anesthesia.

  2. Excavate all of the decay.

  3. Prepare around the tooth 360 degrees.

  4. Take an impression of the tooth.

  5. Fabricate a temporary crown.

  6. Send the impression to the lab to make the crown.

  7. Glue in the permanent crown next visit.

Yes, a crown visit will typically take about two visits total. It is more involved and more invasive than a simple cavity filling.



Large cavity

Cavities which have reached the tooth nerve or beyond it are typically considered to be large decay. It is still not too late to treat these cavities but the procedures involved are much more complex and costly as well. If the tooth is in a reasonable condition, a root canal can still be performed to save the tooth. If the tooth is beyond repair, it may need to be extracted instead.


Large cavity that can be treated with a root canal

If enough tooth structure remains that you can still fit a crown on after cleaning out the decay and the nerve, you can proceed with a root canal. However, if you are unable to place a crown on afterwards, you may be better off by just taking the tooth out.


large cavity that can still be root canal treated
large cavity that can still be root canal treated

Process for a root canal:

  1. Give local anesthetic.

  2. Drill out all tooth decay.

  3. Remove the tooth nerve.

  4. Fill in the canals with a root filling material.

  5. Return to your dentist on a different appointment for the crown.


Large cavity that must be extracted

If your cavity causes you pain AND it is missing the majority of the tooth structure, the tooth may not be able to be saved. In this case, it would be a waste of your time and money trying to save this tooth with a root canal if it is going to end up getting extracted anyway. Therefore you should just go ahead and have the entire tooth removed.


tooth broke off at gum line due to large cavity
tooth broke off at gum line due to large cavity

Process to remove the tooth:

  1. Administer lidocaine to numb the tooth.

  2. Cut the periodontal ligament to release the tooth.

  3. Elevate the tooth with a small elevator.

  4. Deliver the tooth with forceps after it becomes loose enough.

  5. Clean out the socket with a currette.

  6. Irrigate any debris in the socket with saline.

  7. Stitch up the hole if needed.



When is it too late to fill a cavity?

It is never too late to treat a cavity with pain but it can be too late to do a cavity filling if the decay is excessively large. What we mean by large is if the decay involves the nerve or it encompasses more than 50% of the entire tooth.

  • Cavity into the nerve. If the decay has reached the tooth nerve, a filling would be insufficient because fillings don't treat nerve pain. Only a root canal can remove an infected nerve and get rid of nerve pain.

  • Involves more than half the tooth. If the decay is greater than 50% of the tooth, a filling would not be sufficient in protecting the integrity of the tooth. A crown is recommended instead to provide it with better protection.

Although sometimes if the tooth is severely broken down by decay, it may be better to just have it extracted. That is the worse case scenario and it is the reason why you shouldn't wait for treatment if the cavity is already causing you pain.


Tooth fillings are only meant for small sized cavities so it is too late when it is no longer small.



How long can I go with cavity pain?

How long you can go on with cavity pain would be completely dependent upon your pain tolerance level. If you have a high pain threshold, you can try to endure it for as long as possible.


However, that is not what we recommend even if you can tolerate a severe toothache because tooth decay is not static. They will grow and progress through the stages of tooth decay. If you leave it untreated, it will get bigger and consequently require more complex and more expensive treatment. If you want to save some money and do good for your health, you should have it taken care of as soon as you feel tooth pain.



What happens if I don't do anything?

Cavities will not go away on their own and thus if you're having a toothache from it, it will most likely persist. It will hurt you until you finally decide to do something about it, which usually entails making an appointment with your dentist.


Untreated cavities will progress and develop. If that does not concern you, maybe the increasing level of pain will. Advanced stage cavities can cause an unbearable toothache that is so extreme that you may not even be able to sleep! You can try sleeping but it'll simply wake you up after a few minutes. It will seriously disrupt your life until you give it the attention that it deserves.


A toothache that severe isn't one that you want to experience more than once in your life. Trust us, you don't want to know what it is like.



Takeaway

It is never too late to have a cavity treated even if it is hurting you. However it may be too late to do a cavity filling on it if the decay is excessively large. Although other treatment options are available for varying sizes of tooth decay.


Just keep in mind that the longer you wait and put it off, the larger the cavity will grow. Consequently the more complex and more expensive the treatment will be as well. It is your health and your money so we highly encourage you to make the right decision by booking an appointment with your dentist as soon as you feel pain. That is what our long island city dentists always recommend!

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About the author: Dr David Chen, DDS

Hello, I'm Dr Chen and I'm an actively practicing dentist in Long Island City, NY. I graduated from Columbia University College of Dental Medicine in 2016 but prior to going to dental school I was already working in the dental field. It's been more than a decade since I first got to know dentistry and let me tell you, time flies by quickly. Since then I've developed a fondness for writing, which is how this all got started!

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Medical Disclaimer:

This blog is purely meant for information purposes and should not be used as medical advice. Each situation in your mouth is unique and complex. It is not possible to give advice nor diagnose any oral conditions based on text nor virtual consultations. The best thing to do is to go in person to see your dentist for an examination and consultation so that you can receive the best care possible.

The purpose of all of this oral health information is to encourage you to see your dentist and to inform you of what you may expect during your visit. Due to the unfortunate nature of dentistry, there isn't really any true home remedies that will get rid of dental problems. Roughly 99.99% of them require in-person intervention by a healthcare professional.

Hint: That is the reason why you can't eliminate seeing dentists in your life!