If not stopped, plaque, or biofilm, plays havoc with your mouth in an ever-evolving manner:

  1. Plaque bacteria combine with sugar to produce acids in your mouth.
  2. If allowed to accumulate, the acids gradually damage tooth enamel and lead to cavities.
  3. If you don't treat the cavities, decay worsens over time. And more advanced tooth decay stages require more extensive treatments.

If plaque gets a toehold, be aware of the various stages of tooth decay. Even better, learn how you can join your dentist and hygienist in stopping plaque and tooth decay.

Tooth Decay Stages

There are five stages of tooth decay that contribute to cavities. These include:

Stage 1: Demineralization 

This is the first sign of tooth decay that shows up on the surface of the tooth (enamel). Tooth enamel is made up mostly of minerals. When teeth are exposed to acids produced by plaque bacteria, the enamel begins to lose these minerals and wears away. This loss of minerals and enamel wear is referred to as demineralization. Signs of this include white spots on one or more teeth. 

Stage 2: Enamel Decay 

If tooth decay isn’t stopped then it will continue to further erode the enamel. White spots may darken to a brownish color and small holes called cavities can form. Cavities will need to be filled by your dentist.

Stage 3: Dentin Decay

Dentin is the tissue beneath the enamel. It’s softer than enamel and is damaged more easily by acids. Once decay reaches the dentin it may progress at a quicker rate. The dentin also contains tubes that connect to the nerves of the tooth. When this part of the tooth is affected, it can cause increased sensitivity to hot or cold food and drinks. 

Stage 4: Pulp Damage

The pulp is the innermost layer of your tooth. It contains the nerves and blood vessels that help nourish teeth. When the pulp is damaged, it may become irritated and start to swell. This pressure may be placed on the nerves and cause pain. If the roots of the tooth are affected, a root canal or tooth extraction might be necessary.

Stage 5: Abscess

As tooth decay advances into the pulp, bacteria can invade and cause an infection and may lead to an abscess (a pocket of pus forming at the bottom of your tooth.) Tooth abscesses can cause severe pain that may radiate into the jaw. Other symptoms of this type of infection include swelling of the gums, face or jaw, fever, and swollen lymph nodes in your neck. This type of infection can lead to tooth loss or spread to surrounding teeth and bones, resulting in widespread infection. It is serious and must receive immediate treatment. 

How to Prevent Tooth Decay

The best way to prevent tooth decay is through good oral hygiene. Brush and floss twice daily and use a fluoride toothpaste. Fluoride can help remineralize and strengthen teeth.

Before you develop a cavity at this early stage, it’s possible to stop or reverse tooth decay. To accomplish this, your dentist might recommend treatments to:

  • Make the tooth enamel stronger with a product such as topical fluoride.

  • Protect the teeth with a product such as sealants.

Since early tooth decay might not have any symptoms, detection can only happen during a dental checkup. That's why it's important to schedule regular dentist visits.

If you don't seek treatment promptly for tooth decay, you might experience stages that require more intensive dental work, increased sensitivity, pain, and worse.

However, depending on what point your teeth are in a decay stage, there might be treatments available.

Cavity Treatment

If early-stage tooth decay isn't treated, the softened enamel starts to break down, resulting in a cavity.

If you think you have a cavity, see your dentist right away. Treatment depends on the size and location of the cavity.

Your dentist might recommend a filling, which involves removing the decayed portion of the tooth and restoring the area with a filling material. Larger cavities, though, might require crowns, tooth-colored caps that completely cover the teeth.

 If left untreated, your cavity can spread deeper into the tooth and reach the dentin decay, pulp decay or abscess stages.

If the decay advances, the Mayo Clinic reports you might experience symptoms in the affected teeth such as:

  • Sensitivity or even pain when you consume sweet, hot, or cold foods and drinks.

  • Toothaches or pain when you bite down.

  • Visible as holes or pits as the decay worsens.

Complications of Untreated Decay

If untreated decay symptoms are bad, the resulting complications might involve surgery or other invasive treatments.

If untreated, severe tooth decay can result in an infection. A pocket of pus, or abscess, might develop at the tip of the tooth root, explains the Mayo Clinic.

Symptoms of tooth abscesses can include pain, swelling, and fever, notes the American Dental Association. If left untreated, the infection can spread to the surrounding areas, including the jawbone.

Tooth loss is another possible complication of untreated decay.

Preventing Tooth Decay

Fortunately, you can reduce your risk of tooth decay with some lifestyle actions.

Start an oral hygiene routine: It only takes five minutes a day to spend on your teeth.

  • Brush your teeth at least twice a day with fluoride toothpaste.
  • Floss at least once a day.
  • Rinse when a fluoride mouthwash, especially if your dentist recommends it.

Eat a tooth-healthy diet: Food strategies, notes the University of Rochester Medical Center, can make a big difference in your oral health.

  • Eat fruits and vegetables, especially those of the fiber-rich variety, to get healthy saliva flowing.
  • Consume dairy products, such as cheese, yogurt, and milk. Another saliva generator, dairy, also supplies needed vitamins and minerals for tooth enamel.
  • Avoid sugary foods, such as cake and cookies. Can't avoid them? Then eat them during meals when your mouth makes more saliva, which helps in reducing acid. Also, brush after eating these foods.
  • Avoid starchy foods, such as chips, which can cling to teeth and contribute to plaque buildup. Can't avoid them? You know what to do: Brush after eating them.

Ask your dentist for more information about tooth-healthy food choices.

Have regular dental checkups: these visits are crucial so your dentist can identify early-stage tooth decay and treat it before it gets worse.

If you suspect you might have a cavity now, see your dentist immediately. Oral care in the first stage of tooth decay is essential to your overall health.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.


What's behind your smile?

Take our Oral Health assessment to get the most from your oral care routine


2.3 billion

people worldwide suffer from tooth decay


What's behind your smile?

Take our Oral Health assessment to get the most from your oral care routine


2.3 billion

people worldwide suffer from tooth decay