Dental Issues: When to Fill or Extract a Tooth? - Dentistry

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Hello! Thank you for your questions regarding dental issues, particularly about tooth development, cavities, and treatment options. Let's break down your concerns step by step.

1. Tooth Development: Generally, humans have two sets of teeth throughout their lives. The first set, known as primary or baby teeth, typically emerges between 6 months and 3 years of age and consists of 20 teeth. This set is eventually replaced by the permanent teeth, which usually begin to come in around age 6 and continue until the late teens or early twenties, totaling 28 to 32 teeth, depending on the presence of wisdom teeth. So, yes, both incisors and molars are replaced during this process.

2. Cavity Concerns: You mentioned experiencing pain and sensitivity in your last molar, especially when consuming hot or cold foods. This is indeed a sign of a serious cavity, especially if you are feeling sharp pain or a tingling sensation when touching it with your tongue. The presence of black particles when brushing could indicate food debris, plaque, or even decay that has progressed to the point of affecting the tooth structure.
3. Treatment Options: When it comes to deciding whether to fill or extract a tooth, several factors must be considered:
- Extent of Decay: If the cavity is small and has not reached the pulp (the innermost part of the tooth containing nerves and blood vessels), a filling may be a viable option. However, if the decay has progressed significantly, causing pain and sensitivity, a root canal treatment may be necessary to save the tooth. This involves removing the infected pulp and sealing the tooth.

- Tooth Structure: If the tooth is structurally compromised (for example, if a large portion of it is decayed), extraction might be the best option. After extraction, you can discuss replacement options such as dental implants or bridges with your dentist.

- Pain Management: Since you are experiencing significant pain, it is crucial to consult a dentist as soon as possible. They can perform an examination, possibly including X-rays, to assess the extent of the decay and recommend the best course of action.

4. Gum Health: The black particles you see when brushing could also be related to gum health. If you are experiencing bleeding or discomfort in your gums, it may indicate gingivitis or periodontal disease. Maintaining good oral hygiene, including regular brushing, flossing, and professional cleanings, is essential to prevent further issues.

5. Next Steps: I recommend scheduling an appointment with a dentist promptly. They can provide a thorough examination and determine whether the tooth can be filled or if extraction is necessary. If you are concerned about the treatment options or costs, discussing these with your dentist can help you understand your choices better.

In summary, while it is possible to fill a tooth if the decay is not too extensive, your symptoms suggest that you may need more than just a filling. Early intervention is key to preventing further complications, so please seek professional dental care as soon as possible. Thank you for reaching out, and I hope this information helps you make an informed decision about your dental health!