What Are The 5 Stages of Tooth Decay?

stages of tooth decay

Are you aware of the fact that your teeth have five distinct stages of tooth decay? It is in the very first stage of tooth decay where you can take adequate measures to reverse the progression of the disease. 

Hence the first stage of tooth decay is very crucial. The application of fluoride via your toothpaste, fluoride treatments, and even the local water supply can play a pivotal role in stopping the formation of cavities.  

Fluoride can help the cavities from penetrating through the enamel and reaching the second stage. The saliva in your mouth and the foods you eat daily extensively help to remineralize your tooth. But that is just the first stage. What about the other stages of tooth decay? 

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In this article, we discuss something about cavities you might not know and how a cavity progresses. We also discuss the steps you can take to prevent each successive stage from occurring, especially in your child or other family members. 

You may have heard that once the enamel is eroded, it is gone forever. This is not true. In the earliest stage of enamel erosion, a cavity can be reversed by your dentist.

Understanding the Five Stages of Tooth Decay

Tooth decay is the damage caused that can potentially result in tooth cavities, dental abscesses, or even tooth loss. Decay is caused by the activity of certain harmful bacteria that survive in the dental plaque. Hence good oral hygiene plays a crucial role in preventing the progression of oral diseases.

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Dental plaque is the key player in case of the tooth decay process. The bacteria present in your mouth convert the sugars and carbohydrates present in your food into acids. If you allow plaque on teeth to develop over time, these acids can start to damage your tooth enamel. Plaque is a colorless, sticky film that covers the surfaces of your teeth. It is made up of bacteria, food particles, and saliva.

Your dentist will recommend treatments based on the stages of your tooth decay. If you do not clear your teeth, plaque will start to build up. It will harden with time and form a coating called tartar. The presence of tartar will further protect the bacteria, making them all the more difficult to remove.

There are five stages of tooth decay, discussed in detail:

Stage 1: Initial demineralization

The outermost layer of your teeth is composed of a tissue called enamel. Enamel is the hardest tissue found on the human body and is mostly made up of minerals. However, if exposed to acids produced by plaque bacteria, your enamel will slowly begin to lose the minerals.

When this condition happens, you can see a white spot appear on the surface of your teeth. This area where you see mineral loss is actually the initial sign of tooth decay. In this stage, your tooth slowly begins to show signs of strain due to the attack of acids and sugars.

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These white spots will then begin to materialize just below the surface of your enamel. Your dentist can only detect such cavities after a dental examination. 

At this stage, it is quite possible to halt a cavity before it needs a filling. Good dental hygiene can stop the erosion process. The use of fluoride can remineralize your enamel.

Stage 2: Enamel decay

If this process of tooth decay continues, your enamel will slowly start to break down. You might notice the white spot on your tooth darkens to a brownish area. 

During this process, small holes develop in your teeth as the enamel is weakened. This results in the formation of cavities or dental caries. You can read more about dental caries in our other blog post. Your dentist fills tooth cavities.

Stage two of your tooth decay indicates the beginning of the surface enamel attack. Initially, your tooth erosion will occur from the underside outward. This process leads to the outer enamel being attached but will still be intact until the next stage.

Once your tooth cavity starts to break down your enamel surface, there is no turning back. You are only left with the option to have your cavity corrected with a filling.

Stage 3: Dentin decay

If a tooth cavity in your mouth progresses beyond stage two then  – then you would probably start to experience some pain. At this stage, the cavity starts to eat through your second level of tooth material – that lies beneath your enamel – the dentin.

Do you know that dentin is the tissue that lies just under your enamel? Dentin is softer than your enamel which makes it more sensitive to damage from acid. Because of the soft layer, your tooth decay at this stage proceeds at a faster rate. 

The dentin layer also has tubes that link to the nerves of your teeth. Hence when your dentin gets affected by tooth decay, you start to experience teeth sensitivity. You may notice this particularly when you consume hot or cold foods or drinks.

In this stage, your dentist might still use the filling to stop the onslaught of bacteria damage to your teeth. It is done to prevent the cavity from reaching your tooth’s most critical part, the pulp.

Stage 4: Pulp damage

Finally, when this cavity reaches the pulp, it could be painful. So if you have unfortunately missed all the previous stages – your screaming child or moaning teenager will certainly let you know that there is a big problem. 

Your pulp is the third innermost layer of your tooth, consisting of nerves and blood vessels. These nerves help to keep your tooth healthy. These nerves present in the pulp are responsible for providing sensation to your tooth.

When the pulp is damaged, it may start to swell and become irritated. If your surrounding tissues are affected, the tooth can not expand to accommodate the swelling. A pressure automatically builds upon the nerves. As a result, you might experience severe toothache.

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Stage four is serious, and your dentist might suggest root canal treatment. It is the only option of treatment left at this fourth stage. It is perhaps the only way to save your teeth from undergoing a complete extraction. 

Your dentist might offer same-day treatment for crowns and root canals, making the process much less time-consuming or painful. 

Stage 5: Abscess

This is the fifth and final stage of a tooth cavity, and the tooth infection has reached the tip of the root. At this stage, the infection is exciting and irritating the tip of your tooth’s structure. Thus infecting the surrounding tissues and possibly your jawbones. Severe pain can be felt in the affected area.

Your tooth decay becomes so bad that it has advanced into the pulp. The harmful bacteria invade and cause an infection around your affected tooth. You might notice an increased plan and inflammation leading to the formation of a pocket of pus noticed at the bottom of your tooth. This condition is known as tooth abscess. However, it is important to know that a tooth abscess can be fatal if not dealt with immediately, both in children as well as adults.

Tooth abscesses can be very painful and may radiate into the jaw but the whole face. Other symptoms include swelling of the gums, jaw, or face, fever, and at times swollen lymph nodes in the neck region.

In such a serious scenario, a tooth abscess requires prompt treatment. As the chances of the infection might spread to the bones of your jaw and also to your face and neck. In some scenarios, your dentist might opt for a root canal or extract the affected tooth. You should see your dentist urgently in case you have severe toothache and inflammation. 

Tooth Decay Treatments at Various Stages

Your dentist will choose the best treatment option available based on the progression of your tooth decay.

1 Initial demineralization – Using fluoride

As you have seen, the earliest stage of tooth decay can easily be reversed before more permanent damage has occurred. This is achievable by treating your teeth with fluoride.

You can receive fluoride treatment at the dental clinic. It is generally applied to your teeth in the form of a gel. Fluoride strengthens your tooth enamel and makes it more resistant to the acids produced by plaque bacteria.

2 Enamel decay treatment – Teeth fillings

At this second stage, tooth cavities are already existing. Your dentist might use tooth fillings to treat these cavities. During the process, your dentist will use some tools to clear away any decayed material. Then he will fill the hole with a material such as resin, ceramic, or dental amalgam. 

3 Dentin decay treatment – Dental crown

If the decay is identified early, your dentist might treat your dentin decay with a filling. In more advanced scenarios, he might place a dental crown. A crown is a tooth cap that protects the top portion of the tooth above the gums. Your dentist will clean the decayed area and then place the crown. 

4 Pulp damage treatment – Root canal

When your tooth decay has advanced to the pulp, your dentist will suggest a root canal treatment. During a root canal procedure, your dentist will remove the damaged pulp. The cavity is then cleaned, filled and a tooth crown is placed on your affected tooth.

5 Abscess treatment – Tooth extraction

If an abscess has formed on your tooth, your dentist might probably perform a root canal procedure to remove the infection and seal the tooth. Only in severe cases will your dentist remove the affected tooth completely. He will also prescribe antibiotics as part of the treatment. These are medicines that will kill bad bacteria.

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Tooth Decay Prevention

Practicing good oral hygiene is imperative in preventing tooth decay. Below are some valuable tips:

  • Regularly visit your dentist: Your dentist can correctly identify, examine, and treat tooth decay before it gets worse. Just make sure to visit your dentist for routine teeth cleanings and oral exams.
  • Teeth brushing: It is recommended that you brush at least twice every day. Preferably use fluoride toothpaste.
  • Drink tap water: Most tap water contains fluoride. It can help keep your teeth enamel strong and protect them from decay.
  • Avoid snacking: You should strictly aim to limit snacking in between meals. Snacks can provide fuel to the bacteria in your mouth with even more sugars to convert into acids.
  • Limit sweets: Consciously avoid eating foods or beverages with high sugar and carbohydrates like candies, cookies, and soft drinks.
  • Ask about sealants: Dental sealants are recognized as an effective way to prevent pit and fissure caries, especially in children and teens. They are a thin coating of plastic that is applied on the top of your back teeth or molars. Food particles often get trapped in teeth grooves. A sealant can help cover the surface of your molar, preventing decay.

As you might have learned, tooth decay is preventable. Establishing an oral care regimen that involves these above-mentioned preventive measures will help you avoid tooth decay in the future.

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