What Are the Stages of Tooth Decay?

You probably know that a dental cavity is a hole in one of your teeth. And you might also know that a cavity is the result of the process of tooth decay that happens over time. That’s why regular dental visits are a particularly important part of tooth decay prevention – if caught early, tooth decay can be easily treated and possibly even reversed. But exactly what are the stages of tooth decay?

Stage 1: Tooth decay starts with lesions appearing on your teeth

Before a cavity forms, there is an initial lesion on the tooth, which often results in chalky white or brown areas appearing on your tooth’s surface. This is due to a build-up of plaque and is due to the loss of calcium. Bacteria in the plaque eventually begins to metabolize sugars from the food that you eat, and the build up of these acids causes your tooth enamel to deteriorate, which is known as demineralisation.
At this early stage of dental decay, your tooth structure is still intact and damage won’t be visible in any X-rays. Which is good news, because that means tooth decay may still be reversible and further decay may be suspended if you undergo proper treatment. Treatment generally involves using good oral hygiene, brushing properly, using a fluoride toothpaste, and undergoing a topical fluoride treatment when you attend one of your regular dental visits.

Stage 2: Enamel decay results in dental cavity formation

If the lesion on your tooth is allowed to progress, the tooth enamel is affected and starts to breaks down under your tooth’s surface. This is because the natural remineralisation process is unable to restore the proper minerals and enamel, causing a lesion to form within your actual tooth. At this stage of dental cavity formation, the decay of your enamel is visible in X-rays, and if your tooth is damaged enough that the underlying dentin layer of your tooth is exposed, you may experience sensations of pain and/or tooth sensitivity.
Dental restorations like dental fillings are the best option to treat this stage of tooth decay, and your dentist will also work to rebuild missing enamel and restore your ability to chew and bite normally.

Stage 3: Dentin decay leads to dental cavities and tooth sensitivity

If left untreated, acids and bacteria will continue to dissolve the enamel on your tooth and tooth decay can begin to spread beyond the enamel layer. This can affect the dentin of your tooth, which is a porous substance beneath your tooth enamel. When dentin is affected, tooth decay can spread very rapidly, and you may begin to experience sharp pains in the infected tooth.
When enough of the sub-surface enamel is weakened by the loss of minerals and calcium, the enamel collapses and a dental cavity results. At this stage, a filling will definitely be required to restore the tooth and rebuild the damaged structure.

Stage 4: Infection of the dental pulp often results in root canal treatment

Inside the centre of every tooth is a chamber filled with soft tissue known as dental pulp which is made up of nerves, connective tissue and blood vessels, and this is what has assisted in the initial formation of your tooth. Cells of this pulp produce dentin, which acts as the connective tissue between the pulp and the enamel and pulp.
If the pulp of your tooth gets infected with bacteria and reaches the pulp chamber, pus then forms which inadvertently kills the nerves and blood vessels in your tooth. This is known as a root canal infection, and it can be extremely painful.
At this stage of tooth decay, the most common type of dental care is root canal treatment, which involves removing the pulp within the tooth, sterilizing the pulp chamber, and filling the chamber with an inert material, which is then capped off with a crown.

Stage 5: The formation of an abscess often requires tooth extraction

If the infection of the dental pulp spreads to other parts of your mouth like the jawbone and surrounding gum tissue, inflammation and swelling can occur resulting in the formation of an abscess. This is the final stage of tooth decay and is without a doubt the most painful. If the infection reaches the tip of the root of the tooth, the conjoining bones risk infection as well, and this is when advanced dental treatment is needed. This can include tooth extraction, infection control and procedures which can help restore the damaged
structures that have been affected.

Prevention of tooth decay starts with practising good oral hygiene

Preventing tooth decay comes down to a number of factors, with the most important one being that you should practise proper oral hygiene. This means brushing your teeth twice a day, using mouthwash and flossing at least once a day.
However, other dental hygiene tips can also include cutting down on sugar (including natural ones like fruit and honey), avoiding acidic foods like lemons, oranges and soft drinks, and drinking plenty of water to help flush the bacteria off the surface of your teeth.
And of course, don’t wait for the onset of dental pain before you see your dentist. Pain in a tooth means there is inflammation, which means the tooth is probably already affected by decay or infection. If you ignore it, it’s only going to get worse. That’s why it’s recommended that you see your dentist at least twice a year. As they say, prevention is better than cure!