Coast Dental Blog

Prevention & Progression: The 5 Stages of Cavities

You (yes, you!) have more than likely had at least one cavity in your life. And you’re not alone! According to the Center for Disease Control (CDC), about 90% of adults aged 20 and older have had a cavity at some point. Does that mean 90% of us don’t know how to take care of our teeth? Of course not!

Cavities (or ‘caries’) can be attributed to several factors such as diet, income level, physical access to dental care, mental health, and many others. At Coast Dental, we strive to provide care and knowledge without judgement. While we can provide treatment while patients are in our chair, education is key to preventing dental problems from occurring in the first place.

Understanding Cavities

Before diving into the methods of cavity prevention, it’s essential to have a basic understanding of cavities and tooth decay. Cavities develop through a progression of five stages.

Stage 1: Demineralization

The outermost layer of our teeth is comprised of enamel. This mineral layer is the hardest material found in the human body, but even so, it can be broken down through the process of tooth decay. As bacteria builds up on the tooth’s surface, the enamel is exposed to damaging acids and begins to break down – or demineralize. This can manifest as small, white spots appearing on the enamel. It is crucial to address the problem at this stage. While enamel cannot regenerate, further decay can be prevented and even reversed when caught early.

Stage 2: Enamel Decay

If no steps are taken to address demineralization, such as implementing a sufficient hygiene routine or seeing a dentist for fluoride treatment, the enamel will continue to deteriorate. The white spots on the tooth’s surface may turn brown, and eventually, small holes will form. These are cavities, otherwise known as dental caries.

Stage 3: Dentin Decay

Underneath the enamel is a softer layer of tissue called dentin. Once exposed, this can accelerate tooth decay as the dentin is more sensitive to damaging acids when compared to enamel. Dentin also contains pathways (dentinal tubules) that lead directly to the nerves of the tooth. The nerves’ exposure causes sensitivity and discomfort, especially when eating/drinking things that are hot or cold. A filling may be required at this stage to prevent further damage.

Stage 4: Pulp Damage

The pulp is the innermost layer of the tooth. It contains nerves and blood vessels that help to keep the tooth healthy. Once the dentin has eroded, damage to the pulp begins. As the decay progresses, the pulp may become irritated and swell. Because the surrounding tissues in the tooth can’t expand to accommodate this swelling, pressure may be placed on the nerves. This can lead to pain, which may require a root canal to address.

Stage 5: Abscess

As tooth decay advances into the pulp, bacteria can invade and cause an infection. Increased inflammation in the tooth can lead to a pocket of pus forming at the bottom of your tooth, called an abscess. Tooth abscesses can cause severe pain that may radiate into the jaw. Other symptoms that may be present include swelling of the gums, face or jaw, fever, and swollen lymph nodes in the neck. A tooth abscess requires prompt treatment, as the infection can spread into the bones of your jaw as well as other areas of the head and neck. In some cases, treatment may involve extracting the affected tooth or further surgery to remove infected tissue.

“Reversing” Cavities

Unfortunately, once dental caries are fully formed, it is no longer possible to reverse them – only treat them. Cavities are crucial to detect it in the early stages when white spots appear on the teeth. These spots indicate mineral loss, an early sign of decay, according to the National Institute of Dental and Craniofacial Research (NIDCR). Tooth decay can be reversed when addressed in its earliest stages. This may be done with topical fluoride treatments, prescription mouth rinses or toothpaste, a change in diet, and/or a comprehensive oral care routine.

Tips for Prevention

In addition to learning how to reverse decay, it is equally important to adopt preventive measures. Here are some recommendations:

  • Brush your teeth with fluoride toothpaste twice a day.
  • Avoid excessive consumption of sugary foods and drinks, such as candies and soda. If you do indulge, do so during mealtimes and avoid prolonged snacking.
  • Avoid smoking and other drug use.
  • Wait to brush for at least 30 minutes after eating/drinking to protect your enamel from acidity found in certain foods. Your saliva helps to neutralize these harmful acids.
  • Regularly visit your dentist for check-ups and professional cleanings to identify and address any dental issues promptly.


Understanding how to reverse decay and prevent cavities is an essential part of maintaining good oral health. By catching cavities in their early stages and adopting effective preventive measures, we can support the natural healing process of our teeth and reduce the risk of developing painful and costly dental problems. Armed with the knowledge of what cavities are and how to prevent them, we trust that you can make the best decisions that will keep you smiling for life!

To schedule your next appointment with us, call (877) 880-1212 or book online today!

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