Destroyed tooth structure does not fully regenerate, although remineralization of very small carious lesions may occur if dental hygiene is kept at optimal level.
For the small lesions, topical fluoride is sometimes used to encourage remineralization. For larger lesions, the progression of dental caries can be stopped by treatment.
The goal of treatment is to preserve tooth structures and prevent further destruction of the tooth.
Generally, early treatment is less painful and less expensive than treatment of extensive decay.
A dental handpiece ("drill") is used to remove large portions of decayed material from a tooth. A spoon is a dental instrument used to remove decay carefully and is sometimes employed when the decay in dentin reaches near the pulp.
Once the decay is removed, the missing tooth structure requires a dental restoration of some sort to return the tooth to functionality and aesthetic condition.
Restorative materials include composite resin, porcelain, gold (seldom nowadays) and in former times dental amalgam (not more used and allowed in several counties).
Composite resin and porcelain can be made to match the color of a patient's natural teeth and are thus used more frequently when esthetics are a concern.
Composite restorations are not as strong as dental amalgam and gold; some dentists consider the latter as the only advisable restoration for posterior areas where chewing forces are great.
When the decay is too extensive, there may not be enough tooth structure remaining to allow a restorative material to be placed within the tooth. Thus, a crown may be needed. This restoration appears similar to a cap and is fitted over the reminder of the natural crown of the tooth. Crowns are often made of gold, porcelain, or porcelain fused to metal.
A tooth with extensive caries eventually requiring extraction.
In certain cases, root canal therapy may be necessary for the restoration of a tooth. Root canal therapy, also called "endodontic therapy", is recommended if the pulp in a tooth dies from infection by decay-causing bacteria or from trauma.