Unfortunately, nearly everyone has a had a cavity at some point. In fact, the National Institute of Dental and Craniofacial Research estimates that it’s over 90% of the population. What’s worse, researchers think that about 1/3 of adults currently have cavities that they aren’t aware of, which are only growing larger with time. Despite these sobering statistics, you can minimize the damage to your teeth by understanding the 5 stages of tooth decay and the importance of regular checkups with a dentist. By catching and treating cavities in their early stages, you can save yourself a lot of time and money in the dental chair!
Stage 1: Demineralization In the Enamel
Teeth are made of minerals such as calcium and phosphorous and contain 3 layers: hard enamel on the outside, softer dentin in the middle, and the innermost layer where the pulp and nerve reside.
The first stage of tooth decay occurs in the surface layers of the enamel and often shows up as white spots. This is also referred to as demineralization because the enamel loses some of its mineral content. If caught early enough during a checkup exam, this stage of tooth decay can simply be reversed with topical fluoride, which remineralizes the enamel layer.
Stage Two: Deeper Decay In the Enamel
This occurs when a cavity progresses from the surface layer of enamel and makes its way through the entire outer layer of the tooth. It can still technically be reversed with fluoride as long as it stays withinthe enamel layer, but once it reaches the middle layer (dentin), it has to be repaired with a filling or dental crown, depending on the size of the cavity.
Stage 3: Decay In the Dentin Layer
At this stage, the tooth decay has reached the middle layer. Since this is closer to the nerve in the center of the tooth, many people begin feeling sensitivity or pain. Also, since dentin is softer than enamel, a cavity will progress much faster once it reaches this layer, so it’s imperative to catch it as soon as possible and get treatment right away. This prevents the cavity from reaching the pulp, at which point a root canal is often necessary.
Stage 4: Decay Reaches the Pulp and Nerve
At this stage, the decay has reached the pulp, or nerve and blood supply of the tooth. Once here, it causes inflammation, infection, and intense pain. This is when a dentist will recommend a root canal to treat the infected pulp while saving the rest of the tooth structure. The only other option is an extraction.
Stage 5: Abscess and Infection
The last stage of tooth decay occurs when the infection has gone all the way through the tooth to the tip of the roots. This leads to an abscess (an accumulation of pus), swelling, and severe pain. In addition, the infection can spread to other areas of the body such as the brain and become life-threatening if it’s not treated with either a root canal or extraction.
The Importance of Regular Checkups
Now that you understand how a cavity progresses over time, you can see how important it is to get regular checkups. When a cavity is caught early enough, a dentist can recommend the easiest restorative treatment, which will also be the least expensive and least painful!
About the Author
Dr. Suzan Rismani-Flenniken has over 20 years of experience as a general, cosmetic and restorative dentist. She’s a firm believer in the importance of routine dental care to find tooth decay early and help her patients avoid major dental work like crowns and root canals as much as possible. If you have any questions about cavities or your oral health in general, you can reach her via her website.