How Are Cavities Treated Today?

Today, cavities are treated by removing the decayed part of the tooth with a high-speed drill or laser and filling the space with composite resin, glass ionomer or other restorative materials. The procedure is usually painless thanks to local anaesthesia and takes 20 to 60 minutes for a routine filling at a modern dental clinic.
If that sounds a long way from ancient dentistry, that’s because it is. In May 2026, researchers published evidence suggesting a Neanderthal living around 59,000 years ago may have deliberately drilled into a decayed tooth to relieve pain. The discovery pushes back the earliest known evidence of cavity treatment by tens of thousands of years and reveals something remarkable about our ancestors: they understood that tooth pain had a cause and attempted to do something about it.
Today, patients across Parramatta and Western Sydney have access to advanced diagnostic technology, comfortable treatment environments and modern white fillings at our Parramatta clinic. Yet despite the enormous technological differences, the goal remains surprisingly similar to that of the Neanderthal patient from 59,000 years ago: relieve pain, preserve the tooth and restore normal function.
The history of cavity treatment tells a fascinating story about how humans have dealt with one of the most common health problems in history.

The Discovery That Rewrote Dental History

Researchers examining a molar discovered in Chagyrskaya Cave in Siberia identified evidence of what appears to be deliberate drilling into a decayed tooth. The findings, published in PLOS One in 2026 (Zubova et al., Earliest evidence for invasive mitigation of dental caries by Neanderthals), suggest a Neanderthal used a stone tool to access and remove infected tissue within the tooth.
The tooth showed signs of healing and continued use after the procedure, indicating the individual survived and continued eating normally.
Importantly, researchers are careful not to suggest that Neanderthals had dentists in the modern sense. However, the discovery does provide evidence that they understood the relationship between tooth pain and disease within the tooth itself.
The finding has become one of the most significant discoveries in the history of dentistry because it represents the earliest known evidence of intentional cavity treatment.
For modern patients, it also provides an interesting reminder that tooth decay is far from a new problem. Humans have been dealing with cavities for thousands of generations.

Why Cavities Happen Then and Now

Cavities occur when bacteria within dental plaque produce acids that gradually dissolve tooth enamel.
While ancient populations often consumed less refined sugar than modern societies, they were not immune to dental disease. Natural sugars, carbohydrates and poor oral hygiene could still contribute to decay.
Today, we understand much more about the role of sugar in tooth decay and the process of demineralisation that leads to cavities.
When left untreated, decay progresses through the enamel and into the dentine beneath. Eventually, bacteria can reach the pulp, which contains nerves and blood vessels. At this stage, pain often becomes severe and more extensive treatment may be required.
Modern dentistry focuses heavily on early detection and preventive dental care because cavities are much easier to manage before they reach this advanced stage.
Interestingly, the Neanderthal tooth discovered in Siberia appears to have been treated only after the decay had become quite extensive. Modern dentists aim to identify problems long before that point.

Ancient Cavity Treatments: Stone Tools, Beeswax and Worm Theories

The Neanderthal discovery may represent the earliest known evidence of cavity treatment, but it was only the beginning of humanity’s long relationship with dental disease.
Around 5,000 years ago, Mesopotamian texts described a theory that toothaches were caused by tiny worms living inside teeth. Known as the “tooth worm theory”, this belief persisted across multiple cultures for thousands of years.
While incorrect, it demonstrates how strongly people sought explanations for dental pain. Ancient Egyptians appear to have experimented with a range of dental remedies, including mixtures containing honey and medicinal herbs. Some archaeological evidence suggests beeswax may have been used to fill damaged teeth in certain cases.
In ancient India, texts described dental hygiene practices, including chewing sticks and early oral cleaning techniques. Chinese medical writings also documented treatments for tooth pain and gum disease.
Meanwhile, the Etruscans of ancient Italy became known for surprisingly sophisticated dental work. Archaeologists have discovered evidence of gold dental appliances and tooth replacement methods dating back more than 2,500 years.
Many of these early treatments were designed to manage symptoms rather than address the underlying cause of decay. Pain relief was often the primary objective.
Without anaesthesia, antibiotics or modern instruments, treating dental disease remained a significant challenge.

The Medieval and Pre-Modern Era: Barbers, Extractions and Folk Remedies

For much of the medieval period, tooth extraction became the dominant solution to dental pain.
If a tooth hurt badly enough, it was often removed.
Many dental procedures were performed not by dentists but by barber-surgeons. These practitioners carried out a wide variety of medical procedures, including bloodletting, wound treatment and tooth extraction.
Treatment options were limited.
Herbal remedies, alcohol, poultices and various folk treatments were commonly used to manage discomfort. Some were harmless. Others were ineffective or potentially dangerous.
The lack of effective anaesthesia meant dental treatment could be a frightening experience.
As a result, many people delayed seeking care until pain became unbearable.
Despite these limitations, knowledge continued to develop slowly. Dental practitioners began documenting techniques and sharing observations. Over time, a more scientific understanding of oral disease started to emerge.
The foundations of modern dentistry were beginning to form.

The Industrial Revolution of Dentistry: 1700s to 1800s

The 18th and 19th centuries transformed dentistry from a collection of isolated practices into a recognised healthcare profession.
A key figure in this transformation was Pierre Fauchard, often referred to as the father of modern dentistry. His influential 1728 publication brought together knowledge about oral anatomy, dental disease and treatment techniques in a way that had never been done before.
For the first time, dentistry began moving away from folklore and toward evidence based practice.
During this period, dentists experimented with various filling materials including gold foil, tin and other metals.
New instruments also appeared.
The late 1700s saw the development of early mechanical dental drills. These devices were slow and labour intensive compared to modern equipment, but they represented a major advance in the ability to remove decay rather than simply extract teeth.
The concept of preserving a damaged tooth became increasingly important.
Instead of accepting tooth loss as inevitable, dentists began developing methods to restore and maintain natural teeth whenever possible.
This shift laid the groundwork for the restorative treatments that would define modern dentistry.
By the end of the 19th century, dentistry was evolving rapidly and many of the technologies we take for granted today were beginning to emerge.

The 20th Century: Amalgam, Composite and the Modern Drill

The 20th century transformed cavity treatment more than any period before it.
For thousands of years, treating tooth decay was often painful, unpredictable and focused on relieving symptoms rather than preserving teeth. Advances in materials, technology and anaesthesia changed that completely.
One of the most important developments was the introduction of local anaesthesia. By the early 1900s, dentists could numb a treatment area effectively, making restorative procedures significantly more comfortable for patients.
Dental materials also improved.
Amalgam fillings became widely used because they were durable, relatively affordable and suitable for restoring teeth damaged by decay. As dental science continued to evolve, researchers developed tooth coloured materials that offered a more natural appearance.
The development of amalgam, composite resin and ceramic restorations reflects the evolution of what modern fillings are made from and how dental materials continue to improve.
The invention of electric drills and later high speed handpieces also dramatically improved the precision and efficiency of cavity treatment.
By the second half of the century, dentistry was beginning to resemble the experience patients recognise today.
Digital imaging, improved sterilisation standards, advanced restorative materials and preventive care strategies all contributed to better outcomes and longer lasting dental health.

Modern Cavity Treatment Today

Modern cavity treatment is faster, more comfortable and more conservative than ever before.
Many of the advances highlighted in the biggest dental revolutions of the last decade have made it possible to detect and treat decay earlier, often before significant damage occurs.
For most patients, cavity treatment begins with a thorough examination to determine the extent of the decay. Depending on the condition of the tooth, treatment may involve removing the damaged portion of the tooth and restoring it with a filling material designed to protect the remaining tooth structure.
The focus of modern dentistry is to preserve as much healthy tooth structure as possible while restoring strength, function and appearance.
At Parramatta Dental Avenue, modern white filling treatments are commonly used to treat:

• Cavities caused by tooth decay
• Chipped or damaged teeth
• Small cracks in teeth
• Exposed root surfaces caused by gum recession

Because composite resin can be carefully shaped and colour matched to your existing teeth, white fillings provide a natural looking restoration that blends seamlessly with your smile.
For some patients with early stage decay, newer treatment approaches may allow decay to be treated without traditional drilling or injections. These techniques can be completed quickly and comfortably in suitable cases, helping patients address cavities before they become larger problems.
If you are experiencing tooth sensitivity, discomfort or signs of decay, our team can assess your options and determine the most appropriate treatment for your situation.

Speak to Our Team About a Filling

If you’ve noticed sensitivity, staining or discomfort in a tooth, you can contact our Church Street clinic to discuss whether a cavity assessment may be appropriate.

What a White Filling Appointment Actually Looks Like at Parramatta Dental Avenue

Many patients who have not had a filling for years are surprised by how straightforward modern cavity treatment can be.
At Parramatta Dental Avenue, treatment begins with a thorough examination to assess the tooth and determine the extent of any decay or damage. Your dentist will discuss the findings with you and explain the most appropriate treatment options for your situation.
Depending on the condition of the tooth, treatment may involve removing the decayed portion of the tooth before restoring it with a tooth-coloured composite filling. In suitable cases involving early-stage decay, some patients may also be candidates for newer no-drill and no-injection treatment options.
White fillings are carefully colour-matched to your natural teeth and shaped to blend seamlessly with your smile. Once placed, the restoration is polished to create a smooth, natural-looking result that restores both function and appearance.
Many patients who have delayed treatment are surprised by how comfortable modern cavity care can be. Advances in materials, techniques and diagnostics have made it possible to treat many cavities earlier and more conservatively than in the past.
Located at 356 Church Street, our Parramatta clinic welcomes patients from across Western Sydney and focuses on patient comfort, clear communication and minimally invasive treatment wherever possible. You can also meet our Parramatta dental team to learn more about the dentists providing care.

How to Catch a Cavity Early

The earlier a cavity is identified, the easier it is to treat.
Many people assume cavities always cause pain. In reality, decay often develops silently for months or even years before symptoms become obvious.
Understanding the early signs of tooth decay can help you seek treatment before more extensive procedures become necessary.
Common signs may include:

• Sensitivity to hot, cold or sweet foods
• Visible dark spots on a tooth
• Food becoming trapped in one area
• Roughness or small holes in the tooth surface
• Intermittent discomfort when chewing

Regular check-ups remain one of the most effective ways to identify decay before symptoms develop.
Alongside regular check-ups, daily brushing with fluoride toothpaste, flossing and limiting frequent sugar consumption remain some of the most effective ways to reduce your risk of tooth decay. According to the Australian Dental Association, good oral hygiene habits, fluoride use and regular dental visits play an important role in preventing tooth decay and maintaining long-term oral health.

Schedule a Preventive Check-Up

Routine examinations and preventive dental care can help identify small problems before they become larger and more expensive to treat.

Why Putting Off a Filling Costs You More Than You Think

One interesting lesson from the Neanderthal discovery is that intervention appears to have occurred only after the cavity became severe.
Modern dentistry aims to prevent patients from reaching that stage.
When a cavity is left untreated, bacteria continue progressing deeper into the tooth.
What begins as a small area of decay may eventually require:

• A larger filling
• A dental crown
• Root canal treatment
• Tooth extraction

This is one reason dentists frequently discuss why you shouldn’t put off getting a cavity filled.
Early treatment is typically simpler, less invasive and more affordable than treating advanced decay.
The goal is not simply to remove a cavity. It is to preserve your natural tooth for as long as possible.

Book a Cavity Assessment at Our Parramatta Clinic

Humans have been trying to treat cavities for at least 59,000 years.
Fortunately, modern patients have access to significantly more comfortable and predictable options than a stone drill in a Siberian cave.
From advanced diagnostics and modern restorative materials to patient focused care, cavity treatment has evolved dramatically throughout history.
If it has been more than six months since your last dental check-up, or if you’ve noticed symptoms that may indicate decay, now may be a good time to take action.
You can request a cavity check appointment or  book a check-up online with the Parramatta Dental Avenue team.
The earlier a cavity is identified, the easier it is usually to treat.

Frequently Asked Questions

How Were Cavities Treated Before Modern Dentistry?

Before modern dentistry, cavities were often treated with home remedies, herbal mixtures or tooth extractions. The 59,000-year-old Neanderthal tooth discovered in Chagyrskaya Cave is believed to be the earliest known evidence of intentional cavity treatment, showing that humans have been attempting to manage tooth decay for thousands of years.

What Is the Earliest Evidence of Dentistry?

The earliest known evidence of cavity treatment comes from a Neanderthal molar discovered in Siberia and published in PLOS One in 2026. Researchers found signs that a stone tool had been used to drill into a decayed tooth, making it the oldest known example of invasive dental treatment.

How Are Cavities Treated Today?

Modern cavity treatment involves removing the decayed portion of the tooth and restoring it with a filling material such as composite resin, glass ionomer or ceramic. In many cases, treatment can be completed in a single appointment and may take as little as 20 to 60 minutes.

Are Modern Fillings Painful?

Most patients find modern fillings far more comfortable than they expect. Local anaesthesia is commonly used when required, and some cases of early-stage decay may even be suitable for no-drill and no-injection treatment options. Your dentist will discuss the most appropriate approach for your situation.

What Materials Are Modern Fillings Made From?

Modern fillings are commonly made from composite resin, glass ionomer or ceramic materials. Composite resin is particularly popular because it can be colour-matched to the surrounding tooth, creating a natural-looking restoration that blends with your smile.

Can a Cavity Heal on Its Own?

Once a cavity has formed and created a hole in the tooth, it cannot repair itself. However, very early stages of enamel demineralisation may sometimes be stabilised through fluoride, improved oral hygiene and professional preventive care. Early diagnosis gives you the best chance of avoiding more extensive treatment.

How Often Should I Check for Cavities?

Most people should have a dental check-up every six months, although your dentist may recommend a different schedule depending on your oral health needs. Regular examinations help identify cavities early, often before symptoms such as pain or sensitivity develop.