Stages of Tooth Decay

  Amazing Smiles Team   Estimate Reading Time: 4 minutes

Tooth decay begins when your tooth’s enamel breaks down, creating a small pocket (hole) in the tooth. It is standard for tooth decay to go undetected, particularly in areas less visible in the mirror or between the teeth. Tooth decay can lead to tooth loss or gum disease if left untreated.

tooth decay

Usually, decay occurs from the build-up of bacteria on the teeth that have accumulated from foods and liquids left in the mouth. Poor oral hygiene escalates the build-up of harmful bacteria.

Below is a basic graph of how tooth decay may worsen if left untreated.

stages of tooth decay

Five Stages of Tooth Decay – what are the symptoms?

  1. Demineralisation‌ – These are the first signs of decay identified as white, brown or dark surface staining on your tooth. It is caused by the initial weakening of your tooth from harmful bacteria and acids that form plaque. During this stage of tooth decay, the damage is reversible with good oral hygiene and proper treatment. Proper brushing, fluoride treatment, mouthwash and dental visits will help protect your tooth from tooth decay advancing.
  2. Enamel Decay‌ – When the surface stains or legions on your teeth begin to advance, the tooth enamel begins to weaken. During this process, the natural remineralisation process of your tooth cannot replenish the minerals and enamel. The outer layer of enamel begins to deteriorate, and cavities begin to form. Cavities are visible and detectable in x-rays. Dentists treat this point of decay with fillings after removing the damaged area of the tooth.
  3. Dentin Decay – Dentin is the substance beneath the tooth enamel. When dentin is damaged, the decay spreads very rapidly. At this stage, you may experience sharp pains while eating or drinking. Dentists can treat this phase with filling materials.
  4. Damaged Pulp – As acids and bacteria break down the outer layer of your tooth, it begins to spread deeper into the tooth. The dental pulp is the layer underneath the dentin. It is also the most sensitive and vulnerable part of your tooth, housing blood vessels, connective tissues and nerves. When the dental pulp becomes infected with harmful bacteria, pus begins to form, killing the nerves and blood vessels within your tooth. The pain experienced in this phase is excruciating. Root canal treatment is the most common form of dental care to treat this level of tooth pain.
  5. Abscess Formation‌ – This is the final stage of tooth decay, whereby bacteria forms inside the pulp. Consequently, leading to infection and, eventually, a gum abscess forming at the bottom of your tooth. Gum abscesses cause severe pain and discomfort, spreading throughout the gum, mouth and jaw regions.

How to treat tooth decay?

Enamel or Dentin decay can often be resolved with dental filling when detected early. The filling material may consist of resin, ceramic, or dental amalgam.

Depending on how far tooth decay has occurred, advanced levels of dentin decay may require a dental crown.

Upon the third & the fourth stage of the illustration above, where decay has reached the pulp of the tooth, root canal therapy (RCT) is recommended to help save the tooth.

Root Canal Therapy removes the damaged pulp with the cavity cleaned and filled. A dental crown is placed over the affected tooth to appear natural and unnoticeable.

The latest stage pictured below is often the most common cause of tooth pain. Swelling of the gum usually occurs at this point, further attributing to the pain and potentially gum disease.

Unfortunately, in the final stage and most severe cases, the tooth may require extraction when left untreated, and gum disease advances.

Good oral hygiene is the best form of preventing tooth decay. Early detection is part of why regular dental visits (once every six months) are essential for the longevity of natural teeth.

We can help protect your teeth against further Dentin Decay

To help maintain the health of your teeth or for aesthetic improvements to your smile, contact your nearest Amazing Smiles dental clinic:


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