5 Stages of Tooth Decay and Tips for Prevention

Parents and healthcare professionals warn you from childhood that eating sugary foods is bad for your teeth, and they're right. These and other carbohydrate-dense foods contribute to the formation of plaque and begin the process of tooth decay.¹

However, while cavities occur most frequently in children, they can also show up in aging mouths — especially with poor oral hygiene.¹ To explore just how the tooth decay process works, we've broken down the five stages of tooth decay, as well as treatment and costs for each stage.

Stage 1: Demineralization

Enamel, the protective coating on your teeth, is the hardest tissue in your body — and yet it's no match for the plaque bacteria in your mouth. The first stage of tooth decay is when the plaque wears away the enamel, producing little white spots.²

Treatment: Fluoride

The good news is that with the quick intervention of fluoride treatment, you may be able to stop and even reverse the decay.³

Your dentist can administer an in-office fluoride treatment, which costs around $30 to $35 per treatment. They may also point you toward products you can take home, such as fluoride-containing toothpaste, rinses, gels and foams.⁴

Stage 2: Enamel Decay

If you don't catch and reverse tooth decay at the demineralization phase, the next stage is true decay of your enamel, resulting in brown spots. These brown spots become cavities (or caries) that can't be reversed.³

Treatment: Tooth fillings

You'll most likely need to get tooth fillings to keep these cavities from widening and doing further damage to the tooth. Your dentist will drill out the decay and fill it with some sort of agent, such as composite resin, ceramic or porcelain, gold or silver amalgam.³

Fillings can range in price per tooth, depending on the materials used and the number of surfaces. Below, you can see the average cost and range of prices* for fillings — per material type and per tooth, without insurance coverage.⁵

Average cost of tooth fillings

Stage 3: Dentin Decay

Beneath your tough enamel is another part of the tooth, known as dentin. Dentin is comprised of tiny little hollow tubes, so when the protective enamel wears away, these tubes allow food and drinks to reach inside the tooth to the nerves and inner cells, causing heightened sensitivity.⁶

By stage three, tooth decay progresses much more rapidly, and you may notice the decay more significantly. This is because it causes pain and sensitivity when eating or drinking hot or cold foods and/or when eating sugary foods.³

Treatment: Tooth fillings or dental crowns

Depending on the stage of dentin decay, you might be able to correct the damage with a filling. However, if the damage is significant, you may need to have all or part of the tooth removed and replaced with a crown, which covers the remaining tooth parts.⁷

Below are the average costs* of a crown, per tooth, without insurance.⁵

Average cost of dental crowns

Stage 4: Pulp Decay

As you move deeper into the tooth below the dentin, you find the pulp chamber, where the most tender, soft tissue exists, including nerves, blood vessels and other connective tissue.⁶

If decay reaches the pulp, this can cause pressure, pain and swelling in the tooth. If you don't treat it, it can lead to death of this tissue, known as pulp necrosis. Symptoms of pulp necrosis include:⁸

• Color changes in the tooth — it may turn gray or black
• Unpleasant odor emanating from the tooth
• Swelling in and around the tooth
• Bad taste in your mouth

Treatment: Root canal

At this stage, the only treatment is a root canal. A dentist will excise the damaged or necrotic pulp, fill in the cavity and put a crown on the tooth.⁷

Below are the average costs* of a root canal without insurance, depending on which tooth and other factors (such as location of the tooth and complexity ).⁵

Average cost of root canal

Stage 5: Abscess

If you haven't treated your tooth decay at any prior stage, bacteria can get into your decaying pulp, inevitably leading to infection. This can create an abscess — a pocket of infected tissue and pus — at the base of your tooth.⁹

An abscess can cause pain and swelling not just in the tooth, but also across your mouth and face.³ It's important to address this soon, because if not treated, the infection can spread to the bones of your jaw or face.⁹

Treatment: Tooth extraction

A root canal may be the fix for this.⁹ But if that doesn't suffice, you may need to have the entire tooth removed, known as an extraction.⁷ You will also likely have to take antibiotics.⁹

Below are the average costs* for extractions without insurance.⁵

Average cost of tooth extraction

Tips to Help Prevent Tooth Decay

Now that you know what happens at each stage if tooth decay is left unchecked, it's time to learn how to prevent it.

Remember that fluoride is your friend

Dentists talk a lot about fluoride, a natural mineral that helps slow and prevent demineralization of teeth.² Depending on where you live, fluoride might already be in the drinking water, but it can also be found in toothpaste.² It comes as a topical gel, too.⁴

Minimize added sugars

While a certain amount of sweets may be impossible to avoid, it's important to stay away from added sugars, especially in babies and young children. Little ones should not be consuming juice drinks or soda before the age of 2, and even after, these beverages should be limited.²

Maintain good oral hygiene

Basic oral hygiene is crucial to preventing tooth decay. Even babies need their teeth brushed (with a tiny amount of age-appropriate toothpaste) until they're around 3 years old.² Everyone should brush their teeth twice a day — once in the morning and once before bed — and floss at least once daily.¹

Consider a mouth rinse

If brushing teeth is inconsistent, or if there are other issues such as braces or retainers, it's a good idea to add a fluoride mouth rinse.²

Dental Financing With the CareCredit Credit Card

Regular dental checkups are important to help prevent, identify and treat dental problems before they become more advanced. The CareCredit credit card can help you pay for dental exams, cosmetic dental procedures and other costs that insurance doesn't cover — to help you keep your pearly whites bright and healthy.** Use our Acceptance Locator to find a dentist near you that accepts CareCredit. Make the most of your wellness journey by downloading the CareCredit Mobile App. You can find a provider on the go, manage your CareCredit account and easily access the Well U blog for more great articles, podcasts and videos.

In addition to dental care, you can also use your CareCredit credit card for pet care, cosmetic, vision, hearing, health systems, dermatology, pharmacy purchases, spa treatments and so much more within the CareCredit network. How will you invest in your health and wellness next?

Author Bio

Jordan Rosenfeld has been freelance writing for 21 years about finances, health, education and more. Her work has appeared in The Atlantic, The Billfold, GOOD Magazine, GOBankingRates, DailyWorth, Quartz, Medical Economics, The New York Times, PayPal, The Washington Post and more.