I saw a patient today who I’d recommended a crown on about 6 months ago. She came in to the office and said, “OK, I’m ready to get it done!”. When I took a look at the tooth, the tooth had a crack that went all the way through it. There was no way to save the tooth and it had to be pulled. Unfortunately this is an all too common situation. I’ll see someone, recommend treatment, and they’ll disappear for 6 months to a year. Sometimes they don’t get treatment done because they can’t afford it. In other situations they don’t do it because they’re too busy or just don’t make it a priority. When they come back that small cavity has turned large, that medium sized cavity has turned into a root canal, or that tooth that needed a crown has turned into an extraction. In just about every situation, it ends up costing a whole lot more money to fix the new problem. So when can you safely put off dental treatment and when should you get it done as soon as possible?
Small cavities usually can be put off for some time. In the early stages they tend to spread slowly. If you maintain a good diet and brush and floss well, sometimes they won’t spread at all.
Medium to large cavities should not be put off for any long amount of time. These cavities tend to spread rapidly and the tooth often ends up needing a crown, root canal, or extraction the longer you wait. Crowns, root canals and dental implants are far more expensive than a filling.
Teeth that need root canals shouldn’t be put off. They can either get so bad that they need to be extracted or they can get infected, causing you swelling, pain, and in rare cases infections that spread to the rest of the body.
Teeth that need crowns largely depend on the specific situation. If it needs a crown because of a cavity, you should get it done as soon as possible. If it needs a crown because it has already had a root canal, you should get it done as soon as possible. If you need a crown because the tooth is already broken, you can usually put it off for longer than most other cases as long as it isn’t causing you pain.
When orthodontic treatment is recommended for younger children (age 7-12) you should do it soon. Certain types of orthodontic treatment are only possible while a child is growing. Once the growth plates fuse, correcting some types of problems can become very difficult or impossible.
Orthodontic treatment in the late teenage years or as an adult is not urgent. Nothing will likely change to make things more difficult.
Implants should be done soon after having a tooth removed. Your bone shrinks very quickly after having a tooth extracted and in some cases an implant becomes impossible later on unless you have significant bone grafting done.
Gum / Periodontal Disease:
Mild to moderate gum disease can be put off longer than most other types of dental treatment. Severe gum disease should be treated as soon as possible. Gum disease usually doesn’t progress quickly but over time can cause some very significant tooth problems as well as overall health issues.
When in doubt, ask your dentist their honest opinion about how long they would expect before it would become a problem. An honest dentist will usually tell you straight up what problems are urgent and which ones can be put off for some time.