Tooth decay is more than just a dental nuisance — it can lead to bad breath, painful infections, and even tooth loss if left untreated. In fact, the Great British Oral Health Report found that nearly 1 in 3 people in the UK have untreated decay in at least two teeth. That’s a serious issue.
To help you understand what’s really happening when your teeth start to decay, let’s walk through the five stages of tooth decay — and the treatments that can help at each step.
First, What Causes Tooth Decay?
You know that sticky layer your dentist keeps mentioning? Yep, that’s plaque.
It’s made up of bacteria, leftover food, and saliva — and it can start forming just a few hours after you brush. At this stage, brushing and flossing can remove it easily. But when plaque is left too long, it hardens into tartar, which can’t be brushed away and must be removed professionally.
Once tartar sets in, it becomes a stronghold for bacteria — and that’s when real damage starts.
Stage 1: Early Enamel Breakdown
Your enamel is the hard, outer shell of your teeth. When plaque acids attack it, it starts to lose minerals — a process called demineralisation. You might see chalky white spots appear.
How it’s treated: Your dentist may recommend a fluoride treatment or a remineralising toothpaste to help strengthen the enamel. In some cases, tiny white spots can be filled with a tooth-coloured resin.
Stage 2: Enamel Decay
If early decay isn’t addressed, the enamel weakens further and cavities begin to form. These are tiny holes in your teeth that may look brown or dark in colour.
Treatment options: Most cavities are treated with fillings — either metal or white (composite) to match your tooth. These stop the decay and restore function.
Stage 3: Dentin Decay
Under your enamel lies dentin — a softer layer that decays much faster once exposed. It also contains small channels that lead to the nerve of your tooth, so you’ll likely feel sensitivity to hot, cold, or sweet foods.
Treatment options: Your dentist will remove the decay and add a filling to protect the tooth and ease any sensitivity.
Stage 4: Infection in the Pulp
At the centre of your tooth is the pulp, which contains nerves and blood vessels. When decay reaches the pulp, it can be extremely painful — causing persistent aches or sharp pain when chewing.
Treatment options: You might need a root canal to clear out the infected pulp and stop the pain. The area is then sealed, and in most cases, a dental crown is placed to protect the tooth.
Stage 5: Abscess and Severe Infection
If the infection isn’t treated in time, it can lead to an abscess — a painful pocket of pus that forms at the tooth’s root or in the gums. This can be extremely painful and may lead to swelling, fever, or a bad taste in your mouth.
Treatment options: An abscess requires urgent care. Your dentist may need to drain the abscess, do a root canal, or in more serious cases, remove the tooth. If removed, the tooth can be replaced with a dental implant.
The Bottom Line: Prevention Is Everything
The best way to avoid tooth decay is to prevent plaque build-up in the first place. Daily brushing, flossing, and regular check-ups go a long way in keeping your mouth healthy.
Book Your Dental Check-Up in Cheadle
Think of dental check-ups as routine maintenance for your mouth — like an MOT for your teeth. A visit once or twice a year can help catch problems early and save you from more serious (and costly) issues later.
At Cheadle Dental Practice, we offer everything from general check-ups and fillings to implants, cosmetic smile makeovers, and denture repairs.
Let us help you keep your smile strong and healthy — book your appointment today.