tooth decay

Did you know there are five distinct stages of tooth decay? And, that in the first stage of decay, you can actually take steps to reverse the progression of the disease? Indeed, it’s true. In the first stage of decay, whether you’re a child or an adult, the application of fluoride via fluoride treatments, your toothpaste and even the local water supply can stop a cavity from penetrating through the enamel and reaching its second stage. Even the saliva in your mouth and the foods you eat help to remineralize a tooth in jeopardy. But that’s just the first stage! What about the rest? Understanding how a cavity progresses can assist you in preventing each successive stage from occurring in your children. There’s always a lot going on in that little mouth!

What a Healthy Tooth Looks Like

Enamel is the hard outer crystal-like translucent layer. Dentin is the softer layer beneath the enamel that makes the color of your teeth. The pulp chamber contains nerves and blood vessels. It is considered the living part of the tooth.

Stage One (I): White Spots

tooth decay

In stage one, the tooth begins to show signs of strain from the attack of sugars and acids, and white spots will begin to materialize just below the surface of the enamel. These white chalky spots are representative of the demineralization of the tooth and can be easy to miss because they’re likely to occur on your child’s molars. A dental exam, of course, is designed to catch such cavities! Can you see why regular visits to the dentist are recommended? As mentioned previously, at this stage, the cavity can be repaired without the need to excavate the tooth.

What causes the white chalky decay spots, decay, cavity?

  1. Not brushing right after every meal or brush correctly
  2. Not flossing right after every meal or at least at night or floss correctly
  3. The foods that you don’t brush away and floss under the gum feed bacteria. These bacteria eat and drink and have a party every day and night and they produce (poop and pee) acid around your teeth. The acid from their wastes erodes your tooth enamel and dentin every night and day when you don’t brush and floss. The layers of eroded softening of enamel and dentin is call decay. When decay is washed away, it is called cavity (hole) in your teeth.

Stage Two (II): Enamel Decay

tooth decay

Stage II marks the beginning of the end for the surface enamel that is being attacked. Initially, the tooth erodes from the underside outward, so the outer enamel will still be intact for the first half of this second stage. Once the cavity breaks through the surface of the enamel, there is no turning back, and your child will need to have the cavity corrected with a filling.

Stage Three (III): Dentin Decay

tooth decay

If a cavity in your child’s mouth were to progress beyond stage two without you knowing, you’d tend become aware of it when it started to hit stage III because it would probably start to cause some pain. At this level, the cavity begins to eat away at the second level of tooth material that lies beneath the enamel: the dentin. A filling can still be used to stop the onslaught of bacteria assaulting the tooth in order to prevent the cavity from reaching the tooth’s most critical component: the pulp.

Stage Four (IV): Involvement of The Pulp

tooth decay

Once the cavity reaches the pulp, it’s going to hurt. A lot. So if you’ve unfortunately missed all the signs to this point, a screaming child or moaning teenager will certainly let you know there is a big problem. Stage four is serious, and a root canal is the only option of treatment at this Stage. You may feel extreme pain when food pokes a hole and touch the pulp. This is when you have your dentist or Dr. ChauLong Nguyen to take x-rays, do some tests, then do a root canal therapy or use medicines to calm down the tooth first. In difficult situations, Dr. Nguyen may refer you to a specialist called endodontist. Dr. Nguyen also uses the CBCT 3D scanner to scan your difficult tooth to make further recommendation.

Stage Five (V): Abscess Formation

tooth decay

In the fifth and final stage of a cavity, the infection has reached the tip of the root and exited the tip of the tooth’s structure. This in turn infects the surrounding tissues and possibly the bone structure. Swelling would be commonplace and severe pain. In children (as well as adults) an abscess can be fatal or blind if not dealt with immediately. Root canal or extraction would be the order of the day should decay reach this stage.

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As you can see, cavities don’t happen overnight. In the early stages, regular visits can stall and reverse the progression of these dastardly little devils, so it really does pay to visit the dentist at pre-selected intervals. You can keep your kids far from stage five their whole lives, and if a little bit of prodding to get them to the dentist accomplishes that, you can rest easy despite the griping.

tooth decay tooth decay

Before (Left) Patient has short, yellow decay teeth and gummy smile.
After (Right) 6 hours of doing root canal therapy, LASER gum surgery, and composite veneers in One Visit, Patient loves her new smile!

Resources & Images:

Colgate  – Causes of Tooth Decays

TedEd Talk – What causes cavities? – Mel Rosenberg

Revenue Well Blogs