Tooth Decay Stages I-V: What Everyone Should Know - MCR Health

Tooth Decay Stages I-V: What Everyone Should Know

If most of us know that good oral care means brushing our teeth and flossing, why do 1 in 4 US adults suffer from untreated tooth decay (The Centers for Disease Control and Prevention, CDC)? Well, it’s complicated, in part because tooth decay itself can be complicated. But today we’re going to explain.

In this article, we will explore the five stages of tooth decay and discuss what you can do to

be proactive with your dental health.

Stages I and Il

During the first stage of tooth decay, enamel starts to weaken–a process known as demineralization. This occurs when bacteria in plaque resting on the teeth releases destructive acids to destroy the enamel.

Enamel, the hardest substance in the body, is the outer layer of teeth and acts as a defense against bacteria, according to WebMD. When tooth enamel is broken down, teeth become highly vulnerable to harm.

During stage I, white spots began to form on the teeth, this is where plaque has started dissolving the enamel. If left untreated, this can progress to the second stage of tooth decay.

This second stage of tooth decay is characterized by the white spots on the enamel breaking down and turning into brown spots, a process called enamel decay.

WebMD provides some examples of symptoms that may indicate the breakdown of enamel


  • Sensitivity to certain foods that may be sweet or cold
  • Teeth may appear yellow due to the breakdown of the enamel causing discoloration
  • The surfaces of the teeth may become rough
  • Indentation (or cavities) may appear on the teeth after chewing or biting

In this stage, cavities can start forming. You must be proactive with your at-home care by flossing and brushing your teeth with toothpaste.

If left untreated, tooth decay can progress into advanced stages, causing discomfort and the need for more extensive care.

Stages III and IV 

When tooth decay reaches the third stage it is referred to as dentin decay. The dentin layer underneath the enamel layer is softer than enamel, and when the decay reaches this layer, it progresses much faster.

The fourth stage is classified when the tooth decay has progressed to the next layer of a tooth – the pulp. This layer sits beneath the dentin layer and contains the nerves and blood vessels.

If decay has reached the pulp, there are several symptoms that you must watch out for. According to WebMD some symptoms of infected, dead, or dying pulp are,

  • The color of a tooth changes from white, to gray, to black
  • Pain that is described as “throbbing”
  • Unpleasant taste in the mouth
  • Swelling of the gums or the face

If the tooth decay has progressed to the point of damaging the tooth pulp, treatment options include performing a root canal, or having the tooth extracted.  

Stage V 

The final stage of tooth decay occurs when the decay has reached the tip of the tooth root. What happens, according to the Mayo Clinic, is the formation of an abscess (or a pocket of pus) due to bacterial infection.

The Mayo Clinic explains a few symptoms that can indicate possible abscess formation:

  • Severe toothache that can reach the jaw, neck, or ear
  • Sensitivity to cold or hot foods
  • Fever
  • Swelling in the cheek, near the eyes or underneath your jaw
  • Difficulty breathing or swallowing 

Dentists will do their best to save a tooth. But if the decay is severe enough, the only possible treatment may be tooth extraction. Although this treatment may seem extreme, it may be necessary.

Mayo Clinic explains that an “untreated tooth abscess can lead to developing a life-threatening infection known as sepsis.” 

Being proactive with your dental health can help prevent tooth decay before it’s too late.

How We Can Help

We understand the dentist office can be an intimidating experience but good oral health leads to a healthier, longer life. That’s why MCR Health provides oral care for every member of our community in Florida.

By regularly visiting our dentists, you can receive early diagnoses and effective treatment for tooth decay before it’s too late. If you are ready to get quality dental care, schedule an appointment today!  

101 Riverfront Blvd, Ste 100 Bradenton, FL 34205

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