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The Five Stages of Tooth Decay

A woman with closed eyes rubs her jaw in pain.
Author: cmcgovern Posted: November 18th, 2019 Category:

Tooth decay occurs in five distinct phases. Each successive stage is more uncomfortable than the last, and every stage requires a unique method of treatment. 

Tooth decay takes place in five distinct phases, each more uncomfortable than the last. Everyone is at risk for tooth decay, and the risks increase with high sugar consumption. Although tooth decay is an all-too-common consequence of our sugary diets, it is easily preventable with the right knowledge.

What is Tooth Decay?

The tooth decay process begins with dental plaque, a thin biofilm that contains a mixture of bacteria, polysaccharides, and other microscopic particles. Though plaque is naturally-occurring, sugary foods can “overfeed” the bacteria in your plaque. The excess bacteria produce acid that breaks down your enamel. When left untreated, acidic plaque will eat away your enamel and damage the deeper layers of your tooth. 

Stage One: The Spot

The first stage of tooth decay is a discolored spot (usually white or yellow) on the surface of your tooth. This spot is caused by a mineral deficiency due to plaque buildup. You may not feel this spot at first, but it must be reversed before it leads to more serious decay. To reverse a demineralized spot, make sure to brush and floss regularly, and talk to your dentist about getting a fluoride treatment. With care and attention, a demineralized spot will go away without a clinical procedure.  

Stage Two: Minor Sensitivity

If a demineralized spot goes untreated, acidic plaque will begin to break down your enamel. This process makes your enamel soft and porous, which can cause sensitivity in the tooth. This is the beginning of a dental cavity, which cannot be restored with at-home treatment. For an early-stage cavity, your dentist will likely recommend a dental filling. 

Stage Three: Major Sensitivity

If your cavity goes untreated, bacteria can eat entirely through your enamel. The substance beneath the enamel is called dentin, which is softer and more sensitive. When decay reaches your dentin, you will experience major sensitivity, as well as pain while chewing. At this stage of decay, your dentist will likely recommend a large filling, or potentially a dental crown. 

Stage Four: Painful Infection

At the center of your tooth, there is a soft mass of dental pulp. If bacteria travels all the way through your dentin without treatment, your pulp will become infected. This is called a root canal infection, which can damage the nerves at the root of your tooth. At this stage of decay, you will experience intense toothache and difficulty chewing. To treat a root canal infection, your dentist will likely perform a procedure known simply as a root canal. During a root canal, the infected tooth is drained of fluid, the decaying tissue is removed, and a large cavity is filled up with an artificial filler. 

Stage Five: Swollen Abscess 

The final stage of tooth decay is the most serious — and the most painful. If a root canal infection is left to fester, decaying bacteria will reach the bottom of your root. This stage causes intense pain, and it often leads to infection in other areas of your mouth, such as your gums, your jawbone, and even your tongue. A fifth-stage tooth infection will require surgical attention, and potentially tooth extraction. 

Stop Tooth Decay in its Tracks

Good dental hygiene can stop the onset of tooth decay. Regular flossing and brushing, as well as fluoride treatment, can help prevent decay and reverse mineral loss. Minimizing your sugar intake can also reduce plaque buildup. 

Regular trips to the dentist — at least twice a year — are recommended to prevent early-stage decay. For decay that has already reached the cavity stage, a clinical procedure will be necessary to restore your teeth to normal.

For all your dental concerns, Espire offers patient-centered dental care in a calming atmosphere. To prevent or treat tooth decay, give us a call, or visit one of our four locations across the Denver Metro.