This summer, my dentist threw around a word I hadn’t heard since adolescence: Cavity.
I had four cavities, in fact. The dentist assured me they were small and three of them could be filled during one appointment, which happened to fall three days before the triathlon I’d been training for for months.
It had been so long since I’d had a cavity, I wasn’t sure what to expect. Would they numb me? How long would it take? But my biggest question, and the one I was too embarrassed to ask, was is this urgent? The last thing I wanted was lingering pain during the race.
Luckily, I experienced no pain throughout the procedure or in the following days — but I also could have pushed the appointment until the next week.
For filling small cavities, “I wouldn’t put that off for any more than six months,” says Edmond Hewlett, a professor at the UCLA School of Dentistry and a consumer adviser for the American Dental Association. Still, it’s a procedure with a bit of wiggle room.
But what about other dental treatments, like a root canal or teeth whitening? Below, dental experts offer insight into what can wait—and what absolutely shouldn’t—when it comes to your teeth.
Act now: Get to a dentist ASAP
If you’re in any pain, or notice any oral swelling or lumps, call your dentist right away.
When a patient experiences pain, facial swelling or a lump in the gums, it suggests that a chronic infection—like small, surface-level cavities—has advanced into an acute (and more serious) infection, says Shouvik Ponnusamy, an oral and maxillofacial surgeon and member of the Chicago Dental Society.
If an acute infection is left untreated for too long, bacteria in the cavity or abscess can seep into the surrounding bones behind the eye and the lower jaw and into the neck, affecting the airway, Ponnusamy explained—all serious issues that could land a patient in the hospital.
“I have patients, they wake up in the morning and all of a sudden their cheek is swollen,” Ponnusamy says. “For the classic, ‘I woke up and I feel like there’s a lump in my gum,’ any swelling like that, typically means there’s an acute abscess that’s occurred. Whether that’s from a dental cavity or gum disease, that’s something that needs to be treated that day.”
Similarly, if you’ve chipped a tooth and a nerve is exposed, or liquid or air exposure causes pain, reach out to your dentist right away. Even if you’re on vacation and far away from the office, they may recommend seeing a local dentist to evaluate the severity of the chip, Ponnusamy says.
If a chipped tooth isn’t causing pain, it’s still worth giving your dentist a call to make sure it isn’t a sign of other underlying issues, like tooth decay or a filling falling out, Hewlett says.
“You want to know those things,” he says. “If it’s not hurting and you can go to the dentist, make the appointment and see what’s going on.”
Act fast: Make an appointment as soon as you can
Say your dentist detects a cavity at your biannual cleaning. This means an infection has already begun.
“The train has left the station,” Hewlett says. Even if you’re not feeling pain or discomfort, the cavity will grow with time and could eventually cause so much tooth decay that the tooth might break. At that point, you may need a root canal, a crown or to remove the tooth entirely. Your best bet is to schedule a filling as soon as possible.
The same goes for scheduling a root canal or a crown. You may need a root canal if the nerve and side of a tooth is dead or dying, Hewlett says. When the tip of the root and the jaw bone are left untreated, the risk of infection increases. Even if you’re not in pain when the dentist catches it, Hewlett suggests getting the procedure done as soon as possible.
Crowns are used to protect a decaying tooth (or teeth), so don’t put off that procedure, either; you risk losing the tooth altogether if you wait too long.
For a tooth that has decayed to the point that it can’t be salvaged, a dental professional will remove it. Again, don’t hesitate to schedule an extraction.
“That is treating an infection, so that is removing disease,” Ponnusamy says.
Act sooner than later: Schedule within a few weeks or months
For smaller cavities that aren’t causing any pain, patients don’t need to rush in the next day to get them filled, but Hewlett recommends not pushing it off for longer than six months. The longer you wait, the higher the likelihood of an acute infection.
For wisdom teeth removal, the timing depends on whether the teeth are impacted. Impacted wisdom teeth are those without enough room to break through the gums, which puts them at greater risk of infection. You’ll likely want these removed, but the timing is somewhat flexible. Patients can wait to schedule wisdom teeth removal for a time that’s convenient, like after their upcoming wedding or during winter break from school.
“Depending on the situation, dentists say sure, we can wait on this until after the wedding, and that can usually be a recommendation of months rather than weeks,” Hewlett says.
For wisdom teeth that aren’t impacted, meaning they’ve grown in normally, you can leave them indefinitely, but your doctor may advise removing them if you’re experiencing any pain, or if a cyst or infection develops.
Wait as long as you’d like
You can wait indefinitely on any cosmetic or elective procedures, like orthodontia and teeth whitening (unless your teeth are so crowded that it makes cleaning them difficult, which could lead to cavities). If you’ve had a tooth removed, technically you don’t need to replace it with a dental implant, Hewlett says.
“A lot of people, [if] you lose a tooth, nothing bad is going to happen,” he says. “Sure, it’s nice to have a tooth put back in there, but if they don’t mind the way it looks and it’s not affecting their ability to eat, that can actually fall under ‘put it off indefinitely.’ ”
Ultimately, your best bet is to talk to your dentist or oral surgeon to walk through the risks and benefits of every procedure—and the risks of waiting—to help develop a treatment plan that best suits your needs and schedule.