Tooth Decay: When to Extract or Treat Your Cavity

Cavities in molars can lead to the growth of tissue?

Hello Dr.
Lai, I have a tooth with a large cavity.
This tooth was filled by a dentist several years ago, but the filling later fell out for unknown reasons.
I had the dentist refill it, but that filling also came out.
Interestingly, this tooth has not caused me any pain despite the deep cavity, so I have not paid much attention to it since the fillings fell out.
Now, several years later, there seems to be some tissue growing in the middle of the large cavity, which is almost filling it up about 80%.
However, I am more concerned because this tooth has started to bleed recently.
Should I consider extracting this tooth, or are there better treatment options available? Dr.
Lai, I would appreciate your advice.
Thank you!

Jia Jia, 20~29 year old female. Ask Date: 2004/08/14

Dr. Lai Yishao reply Dentistry

There is a large cavity in the tooth with flesh growing in the middle and bleeding.
It is suspected that the decay has penetrated deep into the tooth.
It is advisable to visit a dentist for an examination.
If the tooth structure is too damaged to be restored, it should be extracted as soon as possible to prevent further infection.

Reply Date: 2004/08/14

More Info

Tooth decay, also known as dental caries, is a common dental issue that can lead to significant complications if not addressed promptly. In your case, it sounds like you have a tooth that has undergone multiple fillings and is now presenting with a large cavity, which has developed some form of tissue growth inside it. Additionally, the bleeding you are experiencing is concerning and warrants immediate attention.

Understanding Your Situation
1. Cavity Size and Previous Treatments: The fact that your tooth has been filled multiple times indicates that it has been compromised significantly. Each time a filling fails, it suggests that the tooth structure may be too weak to support further restorative work. The presence of a large cavity can also mean that the decay has progressed deeper into the tooth, potentially affecting the pulp (the innermost part of the tooth containing nerves and blood vessels).

2. Tissue Growth: The "meat" you describe growing inside the cavity could be a form of granulation tissue, which often develops in response to chronic irritation or infection. This tissue can be a sign of underlying issues, such as pulpitis or even an abscess, especially if it is accompanied by bleeding.

3. Bleeding: The bleeding from the tooth is a significant symptom that should not be ignored. It could indicate that the decay has reached the pulp, leading to inflammation or infection. This situation can cause pain, swelling, and further complications if left untreated.

Treatment Options
Given your situation, there are a few potential paths forward:
1. Root Canal Treatment: If the tooth is still salvageable and the pulp is not severely infected, a root canal may be an option. This procedure involves removing the infected pulp, cleaning the inside of the tooth, and sealing it. Afterward, the tooth can be restored with a crown to provide strength and function.

2. Extraction: If the tooth is too damaged or if the infection is severe, extraction may be the best option. This is especially true if the tooth cannot be restored effectively, as leaving a compromised tooth can lead to further complications, including infection spreading to adjacent teeth or the jawbone.

3. Consultation with a Dentist: It is crucial to consult with a dentist as soon as possible. They will perform a thorough examination, possibly including X-rays, to assess the extent of the decay and the condition of the surrounding tissues. Based on their findings, they can recommend the most appropriate treatment plan tailored to your specific situation.

Preventive Measures for the Future
Regardless of the outcome for this particular tooth, it is essential to adopt preventive measures to maintain your oral health:
- Regular Dental Check-ups: Schedule routine visits with your dentist for cleanings and examinations. This helps catch issues early before they develop into more significant problems.

- Good Oral Hygiene: Maintain a consistent oral hygiene routine that includes brushing twice a day with fluoride toothpaste and flossing daily. This helps prevent cavities and gum disease.

- Dietary Choices: Limit sugary snacks and beverages, as they contribute to tooth decay. Instead, focus on a balanced diet rich in fruits, vegetables, whole grains, and dairy products.

In conclusion, given the symptoms you are experiencing, it is advisable to seek dental care promptly. Whether through a root canal or extraction, addressing the issue now can save you from more severe complications in the future. Your dentist will provide the best guidance based on a thorough evaluation of your tooth's condition.

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