Did you know there are five distinct stages of tooth decay? And, that in the first stage of decay, you can actually take steps to reverse the progression of the disease? Indeed, it’s true. In the first stage of decay, whether you’re a child or an adult, the application of fluoride via fluoride treatments, your toothpaste and even the local water supply can stop a cavity from penetrating through the enamel and reaching its second stage. Even the saliva in your mouth and the foods you eat help to re-mineralize a tooth in jeopardy. But that’s just the first stage! What about the rest? Understanding how a cavity progresses can assist you in preventing each successive stage from occurring in your own mouth and in your child’s mouth.

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 back 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 stage, the cavity can be repaired without the need to excavate the tooth.  The dentist and the hygienist are trained to spot these areas and will notify and educate you about how to prevent the weak spot from progressing.

Stage Two: Enamel Decay

 Stage 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 stage. Once the cavity breaks through the surface of the enamel, there is no turning back, and you will need to have the cavity corrected with a filling. This is why it is critical to have regular exams.  When the tooth is at this stage you still may not notice the break in enamel.  The filling will be small at this point if detected early.

Stage Three: Dentin Decay

If a cavity in your mouth were to progress beyond stage two without you knowing, you’d tend become aware of it when it started to hit stage 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.  Or, the tooth may be so weakened, it fractures or breaks. So if you’ve unfortunately missed all the signs to this point, instead of a small filling or a reversible spot, your tooth may become an emergency situation for you. Stage four is serious, and a root canal is the only option of treatment at this stage, save for a complete extraction.  Fortunately, due to advances in dentistry, both of these procedures can be done comfortably for you, but at a much greater expense than preventive measures.

Stage Five: Abscess Formation

In the fifth and final stage 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.  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 stage. You need to call the office right away if this happens so you can be evaluated and most likely prescribed antibiotics.

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 at pre-selected intervals. You and your children can stay away from stage five their whole lives, and if a little bit of prodding to get them to the dentist accomplishes that, you can rest easy despite the griping.  And don’t think cavities are just for kids.  Older adults often end up with recurrent decay around old fillings or crowns due to inadequate oral hygiene, dry mouth due to medications, or other health factors. So remember the old adage you have often heard:  Prevention is the Best Medicine.

Think that only sweet-tasting drinks and snacks are harmful for your teeth? Think again. 

Sugar isn’t the only dietary factor that can damage your smile. Now that we are entering the Holiday Season, it’s a good time to think of what we are eating and drinking.   Foods and beverages that are high in acids wear away the enamel that protects your teeth, a process known as tooth erosion. This changes the appearance of your teeth and opens the door for bacteria that can cause cavities or infection.

 

What Does Tooth Erosion Do to My Teeth?

Tooth erosion is permanent. If your enamel has started to wear away, you may:

• Feel pain or sensitivity when consuming hot, cold or sweet drinks
• Notice a yellowish discoloration of the teeth
• Find that your fillings have changed
• Face greater risks for more cavities over time
• Develop an abscess, in very extreme cases 
• Experience tooth loss, also in very extreme cases

Once erosion occurs, you may need fillings, crowns, a root canal or even tooth removal. Veneers may also be an option to restore the look of your smile.

 

Acidic Foods and Beverages to Watch For

Here’s a quick tip: If what you’re eating or drinking is citrus or citrus-flavored, carbonated or sour, it’s best to limit how much you consume. 

Nutritious, acidic foods like tomatoes and citrus fruits can have some acidic effects on tooth enamel, so eat them as part of a meal, not by themselves. Dried fruits, including raisins, can also cause problems because they are sticky and adhere to teeth, so the acids produced by cavity-causing bacteria continue to harm teeth long after you stop eating them. 

Still, the major erosion culprit is soft drinks, especially soda and sports drinks. Even if they are sugar-free, they are more likely to be acidic thanks to carbonation. That bubbly fizz raises the acid level of any drink, regardless of its flavor. 

Acid in beverages can also come from citrus flavorings such as lemon, lime and orange. Even all-natural beverages like orange juice or fresh-squeezed lemonade are higher in acid than regular water, so make them an occasional treat instead of a daily habit. 

And speaking of treats, some sour candies are almost as acidic as battery acid, and many use citric acids to get that desired effect. If you like a little sour with your sweet tooth, please pucker in moderation.

 

Tips for Protecting Your Teeth

You can reduce tooth erosion from what you eat and drink by following these tips:

• Wait an hour before you brush after eating acidic foods to give your saliva a chance to naturally wash away acids and re-harden your enamel.
• Limit – or avoid – acidic beverages like soft drinks. If you do indulge, use a straw. 
• When drinking something like a soft drink, do not swish or hold it in your mouth longer than you need to. Just sip and swallow. 
• After acidic meals or beverages, rinse your mouth with water, drink milk or enjoy a snack of cheese right afterward. Dairy and other calcium-rich foods can help neutralize acids. 
• Saliva helps keep acids under control. To keep your saliva flowing and protecting your teeth, chew sugarless gum with the ADA Seal of Acceptance. 
• Look for dental health products with the ADA Seal of Acceptance. This means the product is safe and effective, and some have been awarded the ADA Seal specifically because they help prevent and reduce enamel erosion from dietary acids.
• Talk to your dentist. Your dentist can explain the effects of nutritional choices on your teeth, including the various foods and beverages to choose and which ones to avoid. Knowing all you can about the effects of what you eat and drink on your teeth can help keep your smile bright over a lifetime.