4 Stages Of A Tooth Cavity

The final stage of a tooth cavity is painful

You’ve probably had at least one cavity in your lifetime. Don’t worry – you’re not alone! Roughly 92 percent of adults ages 20–64 have had cavities in their permanent teeth.1 The only thing more common than this dental issue is the common cold.2

Cavities, also known dental caries, seem to pop up out of nowhere one fine day! But it isn’t so; the process actually takes some time. Here’s how it happens.


The 4 Stages Of A Cavity

Stages of a tooth cavity

1. Plaque Development

The first stage of a cavity starts with a plaque. This is a tooth’s worst nightmare! Your mouth is full of bacteria, which is perfectly normal and healthy. When you eat, that bacteria (which favors sugar and starch) turns food into acids. This acid teams up with food particles, saliva, and more bacteria. The result? A sticky, colorless substance called plaque.3


The plaque develops within just 20 minutes of eating. And if it isn’t removed, this beginning stage of a cavity progresses.4

2. Enamel Damage

If left undisturbed, the plaque goes on to damage your tooth’s enamel, the outermost layer of the tooth.5 Luckily, this takes a long time! You’ve enough time to stop it before it gets worse!


The key is to regularly brush your teeth with a fluoride toothpaste. This will help the enamel repair itself before turning into a cavity. Even your saliva provides minerals, explaining why dry mouth is linked to tooth decay. You can even get extra fluoride from the water you drink. However, if the enamel isn’t saved, tooth decay will continue. Your dentist might notice a white spot where the minerals have been lost.6

3. Dentin Erosion

Once the enamel is damaged, the next layer of tissue erodes. This is called the dentin, which makes up most of your tooth. It’s also in charge of protecting your tooth’s nerve endings.


Since dentin is softer than enamel, this stage of a cavity happens quickly. It’s also when you start to notice some pain.7 At this point, you’ll have a noticeable hole in your tooth. Your dentist can fill it up with silver alloy, gold, porcelain, or resin. If the damage is pretty bad, he or she may give you a crown or “cap.”8

4. Pulp Erosion

If erosion continues, it hits the pulp, the innermost part of the tooth. This is made up of your tooth’s nerve endings and blood vessels. It runs down to the root of your tooth, which is under the gum.


In this stage, the decay has reached your nerves, making this final stage extremely painful. The tooth will also be super sensitive to hot and cold foods, and eating or talking might become difficult. When the nerve dies, a root canal is the only fix. Your dentist will remove the pulp along with the decayed parts of the tooth. The root will be sealed and then topped off with a filling and crown.9

Cavities aren’t fun, but they’re easy to prevent. Brushing your teeth with fluoride toothpaste can stop early tooth decay. If it’s a regular habit, decay won’t even begin.10 Remember, it’s also important to visit the dentist regularly. By having routine check-ups, a cavity can be caught – and stopped – in the earliest stage.11