Is a filling always necessary to manage dental decay?

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Many patients often ask “do I always need a dental filling if I have decay?”. In short, the answer is NO! Some dental decay can actually be managed without any restorative intervention.

The progression of dental decay can be evaluated via both clinical inspection and radiographic imaging. As per the above diagram, a tooth usually has two layers, enamel and dentine, which protect the nerve and blood supply at the center.

If the decay remains in the enamel layer, it can be managed by concentrated fluoride gel applied by a dental practitioner, toothpaste with fluoride and good oral hygiene. The tooth will need to be reviewed every three to six months to ensure the absence of further progression and evaluate the possibility for a filling or other dental work later.

If the decay progresses into the dentine, a filling is often needed to remove active decay and stop its progression towards the nerve. If the decay is deep and close to the nerve of the tooth, root canal treatment may be needed immediately or in the long term. However, the dental practitioner will always try to manage conservatively. If you start to experience symptoms such as sensitivity to hot, cold or sweet things, pain or soreness on biting and pain that wakes you at night, a root canal treatment is often indicated to relieve the symptom(s) and save the tooth.

In conclusion, it is not always necessary to place a filling when there is tooth decay. However, it is better to have no decay by maintaining a good oral hygiene habit including brushing and flossing, as well as regular check-up and clean from a dental practitioner. Prevention is always the best!