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Stages of tooth decay

Dental plaque is important to the tooth decay process. Plaque is a colorless, sticky film that covers the surfaces of your teeth. It’s made up of bacteria, food particles, and saliva.

If your teeth aren’t cleaned regularly, plaque can begin to build up. It can also harden over time, forming something called tartar. The presence of tartar can help to further protect bacteria, making them more difficult to remove.

Generally speaking, there are five stages of tooth decay. Let’s examine them in more detail below.


Stage 1: Initial demineralization

The outer layer of your teeth is composed of a type of tissue called enamel. Enamel is the hardest tissue in your body and is mostly made up of minerals.

However, as a tooth is exposed to acids produced by plaque bacteria, the enamel begins to lose these minerals.

When this occurs, you may see a white spot appear on one of your teeth. This area of mineral loss is an initial sign of tooth decay.


Stage 2: Enamel decay

If the process of tooth decay is allowed to continue, enamel will break down further. You may notice that a white spot on a tooth darkens to a brownish color.

As enamel is weakened, small holes in your teeth called cavities, or dental caries, can form. Cavities will need to be filled by your dentist.



Stage 3: Dentin decay

Dentin is the tissue that lies under the enamel. It’s softer than enamel, which makes it more sensitive to damage from acid. Because of this, tooth decay proceeds at a faster rate when it reaches the dentin.

Dentin also contains tubes that lead to the nerves of the tooth. Because of this, when dentin is affected by tooth decay, you may begin experiencing sensitivity. You may notice this particularly when having hot or cold foods or drinks.


Stage 4: Pulp damage

The pulp is the innermost layer of your tooth. It contains the nerves and blood vessels that help to keep the tooth healthy. The nerves present in the pulp also provide sensation to the tooth.

When damage to the pulp happens, it may become irritated and start to swell. Because the surrounding tissues in the tooth can’t expand to accommodate this swelling, pressure may be placed on the nerves. This can lead to pain.


Stage 5: Abscess

As tooth decay advances into the pulp, bacteria can invade and cause an infection. Increased inflammation in the tooth can lead to a pocket of pus forming at the bottom of your tooth, called an abscess.

Tooth abscesses can cause severe pain that may radiate into the jaw. Other symptoms that may be present include swelling of the gums, face or jaw, fever, and swollen lymph nodes in your neck.

A tooth abscess requires prompt treatment, as the infection can spread into the bones of your jaw as well as other areas of your head and neck. In some cases, treatment may involve removing the affected tooth.

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