The 5 Stages of Tooth Decay

Did you know there are five stages of tooth decay? And, that in the first phase of decay it is possible to reverse a cavity naturally.  Indeed, it’s true. In the first phase of tooth decay, whether you are a child or an adult, the application of fluoride via  your toothpaste and even the local water supply can stop a cavity from permeating the enamel and reaching its second phase. Even the saliva in your mouth and the foods you eat help to re-mineralize a tooth in danger.

However that is just the first stage! What about the other stages of tooth decay? Understanding how a cavity advances can assist you in preventing each successive phase from occurring in your children. There’s always a lot going on in that little mouth!


Ways to stop a cavity in stage one – Fluoride from toothpaste, fluoride from drinking water, saliva, SDF and foods we eat.


Stage One: White Spots

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 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 phase, the cavity can be repaired without the need to excavate the tooth.  A visual exam by your dentist can pick these spots up in areas of the mouth you can’t see on your own.


Stage Two: Enamel Decay

Phase two 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 phase. 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. It is critical to make regular appointments every 6 months so we can prevent teeth from getting to this stage!


Stage Three: Dentin Decay

If a cavity in your child’s mouth were to progress beyond phase two without you knowing, you’d tend become aware of it when it started to hit phase three 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: Involvement of The Pulp

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. phase four is serious, and a root canal is the only option of treatment at this stage, save for a complete extraction.


Stage Five: Abscess Formation

In the fifth and final stagee 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 pain severe. In children (as well as adults) an abscess can be fatal if not dealt with immediately. Root canal or extraction would be the order of the day should decay reach this phase.

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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 every six months. You can keep your kids far from stage five their whole lives, and if a little bit of prodding to get them to the pediatric dentist accomplishes that, you can rest easy!

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Pediatric Dentists Anchorage Alaska

At Anchorage Pediatric Dentistry, we provide comprehensive dental care for infants, children and adolescents. Our passion and the purpose of our practice, is to provide the best possible pediatric dental care through kindness, education, and excellent treatment.


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