If your decay is in the early stages, your dentist may apply a fluoride varnish to the area, which can help to stop further decay.
If decay has worn away your enamel and caused a cavity, your dentist will remove the decay and restore your tooth with a filling. If the nerve in the middle of your tooth is damaged, you will need to have a root canal treatment, which removes the nerve and restores the tooth with a filling or crown.
If the tooth is so badly destroyed that it cannot be restored, the only option may be to remove the tooth.
Fluoride is probably the most effective treatment available for preventing and limiting the spread of tooth decay. It is a naturally occurring mineral found in foods and drinks, such as fish and tea, but it can also be synthesised (manufactured). Synthetic fluoride is used in toothpaste, from which most people get their fluoride.
Fluoride protects teeth by strengthening the enamel, making teeth more resistant to the acid attacks that can cause tooth decay. It reduces the ability of plaque bacteria to produce acid, and it enhances the repair (remineralisation) of enamel.
If your cavity is in its early stages, your dentist may be able to repair the decay by using a concentrated fluoride gel, varnish or paste.
Fillings and crowns
If the decay to one of your teeth is more extensive, it may be necessary to repair the damage with a filling or crown.
A filling replaces your missing enamel. There are many different filling materials available, including amalgam (silver coloured), composite (tooth coloured) and glass ionomer (tooth coloured).
Inlays and onlays can also be used to fill teeth. They specifically fill the size and shape of your cavity, and are fixed in place with dental cement. Inlays and onlays are usually made from gold, as it is the most long-lasting and hard-wearing filling material.
Crowns are used to treat teeth that have been extensively damaged. The decayed section of the tooth is drilled away and the crown is placed over the remaining section of the tooth. Crowns are made out of gold, porcelain, ceramic or glass.
Root canal treatment
If tooth decay has spread to the pulp, the pulp may have to be removed and replaced with an artificial pulp that will keep the tooth in place. This is known as root canal treatment.
Root canal therapy has had a reputation of being a painful procedure, but modern dental techniques mean it is now relatively painless.
In very serious cases of tooth decay, the tooth may be removed to prevent the spread of infection. Losing certain teeth can affect the shape and function of the surrounding teeth, so the dentist may have to replace the tooth with an artificial implant.
Provision of Dental Care in Ireland
In the Republic of Ireland, some dental services are publicly funded, funded through social insurance or through private health insurance or available from private practices. A range of services are also available through the University Dental Schools and Hospitals in Dublin and Cork. The majority of dentists prvide dental treatment services also.
Publicly Funded Dentistry
Publicly funded services are provided directly by the Health Service Executive Dental Service, based in health centres throughout the 32 Local Health Offices or provided by private dental surgeons with HSE contracts. Since 1994, adults over the age of 16 years with low income who hold a medical card can avail of the contracted service. This is called the DTSS (Dental Treatment Services Scheme).
Children under the age of 16 years and adults with special needs can attend HSE clinics for dental care which according to legislation should include
a) a dental health screening service,
b) a preventive dental treatment service, and
c) a primary care dental treatment service in respect of defects noted during a screening examination carried out under paragraph (a).
There is no other state-funded or subsidised dental service available for children.
Access to this service varies throughout the country but children in certain classes, largely those in national school are targeted for assessment, the application of preventive measures, oral health education, fluoride mouth rinsing and fissure sealing of vulnerable molar(back) teeth. An emergency service is available to those who are not in the target classes.
The HSE Dental service is also responsible for preventive programmes including water fluoridation.
Orthodontic treatment is also available through the HSE Orthodontic service for patients referred by the HSE Dental Service who are eligible for public Orthodontic treatment. Eligibility is based on the severity of the problem. Standardised criteria are used to assess eligibility. Orthodontics solely for cosmetic purposes is not available.
DTSS (Dental Treatment Services Scheme).
Adult medical cardholders over the age of 16 years are eligible for this scheme. It was introduced in 1994 .It is delivered through dentists in private practice who have a contract with the HSE. Examination, scaling, gum treatment, extractions, fillings, root canal treatments and dentures were provided free of charge to the patient. However since April 2010, this service is limited to an emergency service with the exception of patients deemed as high risk. Contact your Local Health Office for information on dentists operating this scheme.
Social Insurance Funded Dental Scheme
The Department of Social Protection operates the Dental Treatment Benefit Scheme (DTBS). Private Dentists provide a range of dental treatments to those who contribute to Pay Related Social Insurance (PRSI). Some treatments are provided free of charge while part of the cost of other treatments must be met by the patient. Spouses of those entitled to this care are also covered.
Useful website links :
A list of dentists operating this scheme is available on the Department of Social Protection website.
Private Health Insurance
A limited number of dental procedures are covered by private health insurance. These generally apply to inpatient oral surgery.
The majority of dentists in Ireland are found in private practice including specialists in Orthodontics and oral surgeons. You will find the dentists available locally in the telephone directory or check the Dental Council website for a list of registered specialists.