You've been ignoring that cavity for two years. It doesn't always hurt, and when it does, you just wait it out. The question that keeps you up: Is it too late to fix it? Or is extraction my only option?

Here's the good news: most cavities are salvageable if they haven't reached the nerve. And even if they have, modern dentistry can save the tooth. What's actually not salvageable is rare, and you're probably not there yet.

The Timeline: How Long Does a Cavity Actually Take to Become "Unfixable"?

It's not a hard cutoff. Cavities progress differently depending on depth, location, and whether you have secondary infection. But here's the arc:

Month 1–6: Early cavity (enamel and dentin)
Filling is straightforward. Cost: $150–$300 in Colombia, $300–$600 in the US.

Month 6–18: Cavity deepening (approaching nerve)
Tooth might start hurting with hot/cold or sugar. Still fillable, but might need onlay or crown instead of simple filling (tooth integrity compromised). Cost: $400–$800 Colombia, $800–$1,500 US.

Month 18+: Nerve involvement
Tooth hurts spontaneously. Needs root canal or extraction. Cost: $800–$1,350 (root canal + crown) vs $1,800–$3,000 (implant) in Colombia.

Year 3+: Chronic infection, bone loss
If you've ignored root canal symptoms long enough, infection spreads to bone. Extraction is now required. Implant placement might need bone graft first.

But here's what matters: you have to ignore the tooth for YEARS for it to become truly unfixable. Most people don't get there.

Filling vs Onlay vs Crown: When Each Makes Sense

Simple Filling
If: Cavity is small to medium, tooth structure is mostly intact
Process: Remove decay, fill with composite resin
Lasts: 5–10 years typically
Cost: $150–$300 (Colombia) | $300–$600 (US)
Limitation: Doesn't strengthen the tooth—if the cavity is large, surrounding tooth can still break

Onlay (Partial Crown)
If: Cavity is large but hasn't compromised tooth beyond repair; tooth needs structural support
Process: Remove decay, place a custom ceramic piece bonded to tooth
Lasts: 15–20 years
Cost: $400–$800 (Colombia) | $1,000–$1,800 (US)
Advantage: Saves more tooth structure than crown, looks natural, protects the tooth

Crown (Full Coverage)
If: Cavity is extensive, tooth has been treated before, or structural integrity is severely compromised
Process: Remove decay and old filling, shape tooth, place ceramic crown
Lasts: 15–30 years
Cost: $400–$700 (Colombia) | $1,000–$1,500 (US)
Advantage: Maximum protection; tooth is fully supported

Root Canal + Crown
If: Cavity has reached nerve; tooth is infected
Process: Root canal (remove infected nerve), then crown
Lasts: Permanently (tooth is no longer living, but fully functional)
Cost: $800–$1,350 (Colombia) | $2,500–$3,900 (US)
Note: This still preserves your natural tooth. It's the "save this tooth" option.

Extraction: When It's Actually the Right Call

Extraction is rarely the best choice anymore. But sometimes it is:

Here's the thing about "I'll just extract and get an implant later": implants are more expensive and more complex than saving a natural tooth. Dentists will push to save your tooth because it's actually better for you, not just better for their business.

The Cost Reality: Ignoring It Gets Expensive

Scenario 1: Address It Now
Cavity caught early → simple filling
Cost: $150–$300 (Colombia) | $300–$600 (US)

Scenario 2: Wait 1–2 Years
Cavity deepens → onlay or crown needed
Cost: $400–$800 (Colombia) | $1,000–$1,800 (US)
Time: 2 visits, possibly 2 weeks apart for crown

Scenario 3: Wait 2–3 Years
Nerve gets infected → root canal + crown
Cost: $800–$1,350 (Colombia) | $2,500–$3,900 (US)
Time: Multiple visits, weeks between appointments

Scenario 4: Wait 5+ Years
Tooth dies, infection spreads, extraction + implant
Cost: $1,800–$3,000 implant (Colombia) | $6,000–$10,000 (US)
Time: Two trips, 3–6 months between stages, months of healing

Cost of waiting: 10–30x more expensive than addressing it early.

The "Is My Tooth Dead?" Question

If your tooth turned dark/gray, it might be dead. But here's what's reassuring: a dead tooth can still be saved. Root canal treatment removes the dead tissue and seals the tooth. Dead tooth + root canal = still your natural tooth, functional for decades.

Only time you truly lose the tooth is if you wait until it's too broken or infected to restore. That's rare unless you ignore it for years while symptomatic.

What Antibiotics Can Do (But Can't Do)

If the cavity has caused infection and abscess, your doctor might prescribe antibiotics. Here's what they do: they buy you time.

Antibiotics can manage active infection for weeks or months. But they can't fix the cavity. Once antibiotics wear off, the infection comes back unless the cavity itself is addressed. So antibiotics + wait = false relief. Antibiotics + filling/root canal = actual fix.

If you're on antibiotics, use that window to get the tooth fixed. Don't wait for them to "solve it."

The Real Talk

Your cavity is almost certainly salvageable. Dentists see cavities that have been ignored for 10+ years, and they still save the tooth most of the time. Whatever you're imagining about "too late"—you're probably not there.

The only thing that gets truly unfixable is: wait so long the whole tooth disintegrates, or wait until infection is spreading systemically (rare, but dangerous). You're not at either of those places.

Step 1: WhatsApp a photo. Step 2: Dentist assesses. Step 3: You know your options and costs. Most likely option: a filling, done, moved on with your life.

You're going to be fine. This is fixable. Let's start.