Unfortunately, not every tooth is a nail and every dentist has a different idea of when it’s an appropriate time to treat tooth decay, (aka cavities). A tooth’s environment, a patient’s history and an estimated rate of progression should be among other factors considered prior to recommending a restoration.
Dental decay occurs along a continuum and has different thresholds at which point dentists recommend treating decay. Training, patient history, philosophy, financial motivation and other factors may influence where a threshold lies for a provider or even a patient. Because of this, different providers will diagnose treatment recommendations differently given the same presentation.
Stages of Cavities/Caries
Under normal conditions, dental decay advances slowly. If cavities are caught early, many dentists will diagnose them as a warning spot or watch spots to see if they advance and need further treatment. So, what are the different stages of cavity formation?
Stage One: White Spots
When a tooth starts to show signs of strain or attack from sugar and acid, bright white spots appear. This is a result of demineralization, which means the minerals that makeup tooth enamel are beginning to break down. More often than not, these white spots appear on the back teeth or molars due to the fact that most food is chewed in the back portion of the mouth- which makes it more susceptible to cavities.
Stage Two: Dark Spots
A dark brown spot on the teeth means enamel has started to completely erode away. Enamel breaks down from the underside outward, so while the enamel may still be intact during this stage, it’s not long until it eventually breaks down fully.
Stage Three: Dentin Decay
Dentin is the bony substance directly underneath the tooth enamel with many microscopic tubes that lead directly to the nerve of the tooth. Once a cavity has reached the dentin, pain will occur. During this stage, many dentists recommend a filling to repair the tooth quickly before it reaches the dental pulp. Exposing the dental pulp leads to extreme pain because the pulp of the tooth holds the nerve, blood vessels and connective tissue- a very sensitive area!
Stage Four: Pulp Infection
When the cavity reaches the pulp, it can become infected and lead to severe dental pain. The only way to address it is with a root canal to remove pulp completely and prevent further infection.
Stage Five: Abscess
This stage refers to when the cavity moves beyond just the tooth and infests the surrounding gums and bone. At this stage, the patient will not only feel severe dental pain but also swelling and sensitivity around the tooth. Left untreated, an abscess can be fatal if not dealt with immediately. To fix this issue, a dentist might recommend a root canal or a tooth extraction.
If you are feeling that your dentist is leading you down a path you are unsure about, contact NoBull Dental to receive a second opinion or find you a dentist better fit for your needs and values.
Dental decay that is in early stages can be arrested for years with proper care
Dental decay can progress quickly in high risk individuals, but often takes years to progress in low risk individuals with good care and proper hygiene
While there are very rare conditions that cause defective enamel, the concept of “Soft Teeth” is a myth
The seams between dental restorations (fillings, crowns, etc) and tooth structure are common areas where decay can start and it can be difficult to clear; this is why the fit of fillings and crowns is so critical to the long term health and survival of a tooth
How can one dentist say I have decay (cavities) and another not?
Why are there discrepancies between and among providers?