Understanding the Early Stages of Tooth Decay: How to stop it?

dental care and prevention
Have you ever noticed white or brown spots on your teeth?

These could be early signs of tooth decay. While it may seem like a small issue, if left untreated, tooth decay can progress and cause more serious problems like severe toothaches and even infections.

But don't worry, there's good news! In the early stages of tooth decay, the condition is still reversible.

In this article, we'll go over everything you need to know about the early stages of tooth decay, including how to identify, prevent, and reverse it.

Key takeaways:

  1. Tooth decay is caused by the breakdown of enamel and dentin due to the interaction of these factors: bacteria, teeth, sugar and time.

  2. Early tooth decay appears as painless white or brown spots on teeth, indicating enamel demineralization. These rough, porous spots are susceptible to plaque buildup.

  3. If untreated, tooth decay can progress, causing sensitivity, pain, and visible holes or pits in teeth.

  4. Early tooth decay can be reversed with products such as fluoride, CCP-ACP, and NovaMin. A healthy diet, good oral hygiene, and professional dental cleanings are also crucial for preventing further damage.

How does tooth decay occur?

Tooth decay is a common disease that affects many people around the world. It's a process that slowly eats away at the hard layers of your teeth, namely the enamel and dentin, and can even progress deeply toward the nerves if left untreated.

Now, tooth decay is a multifactorial disease, which means that there are a few different things that can contribute to its development. One way to understand the factors involved in tooth decay is through the Keyes diagram, which highlights the importance of four key factors: bacteria, teeth, sugar, and time.

Keyes' diagram showing the interaction of four factors in the process of tooth decay: bacteria, sugar, teeth and time.

Let me give you an example of how the Keyes diagram works in practice.

Imagine that you've just eaten something sweet, like a piece of candy. When you consume sugary foods or drinks, the bacteria in your mouth will break down the sugars and increase the acidity of your mouth.

This acidity can then diffuse through the plaque that's on your teeth and penetrate the pores of the enamel. This process leads to demineralization, which occurs when the minerals that make up your enamel (mainly calcium and phosphorus) dissolve by acidic agents.

After some time, your mouth will naturally start to neutralize the acidity and initiate a process called remineralization. During this phase, the enamel can recover the minerals it has lost.

However, if the demineralization process is excessive or lasts for a long time, it can lead to the development of dental caries, which is more commonly known as a cavity.

At the early stages of tooth decay, the damage is limited to the enamel. This can manifest as white or brown spots on your teeth and mean that demineralization is occurring.
The development process of white spot lesions.
The good news is that enamel decay is reversible by applying certain products, such as remineralizing toothpaste or fluoridated gels, or mouthwash. However, if the decay progresses and a hole is formed in your tooth, the damage is irreversible and will require a filling from your dentist.

So it's important to catch tooth decay early and take action to prevent it from getting worse.

How the early stage of tooth decay looks like?

Tooth decay can be tricky to spot in its early stages. The reason is that it's usually painless, as the enamel does not have nerves. This means you may not even realize you have tooth decay until it has progressed to a more advanced stage.

However, there are some signs that you can look out for. Early tooth decay typically appears as brown or white spots on your teeth. They indicate that the enamel is starting to lose its minerals.
white spot lesions on front teeth
In fact, these white spots are only a visual effect. In demineralized areas, light is reflected differently than in the surrounding healthy enamel. As a result, the affected area may appear white and chalky.

As the tooth continues to lose minerals and becomes more porous, it may start to absorb pigmented substances from the food and drinks you consume. This can lead to the formation of brown spots on your teeth.

early tooth decay on a molar

It's important to note that the surfaces of early tooth decay lesions are rough and porous, which makes them more susceptible to trapping plaque. One way to reveal these spots is to stand in front of a mirror, dry your teeth, and apply a light source. You should be able to see white spots that appear dull and less shiny than healthy enamel.

If tooth decay is left untreated and progresses to an advanced stage, you may experience symptoms such as sensitivity to hot or cold, pain when biting or chewing, or even visible holes or pits in your teeth.

So if you suspect you may have tooth decay, it's important to visit your dentist as soon as possible. Early detection and treatment are essential to preventing further damage.

How can we reverse the early stages of tooth decay and stop it from spreading?

When tooth decay is detected in the early stages, it's important to take action to prevent it from progressing further. The good news is that tooth decay in the early stage is reversible.

First, you must see your dentist to assess these lesions and their severity. They will advise you on maintaining good oral hygiene and a healthy diet. They may also recommend treatments to help remineralize the affected area and rebuild the enamel.

Here are some of the remineralizing products available:

  1. Fluoride: This mineral has been shown to help prevent and even reverse early tooth decay by strengthening and remineralizing the enamel. Fluoride can be found in many toothpastes, mouthwashes, and gels. You can also benefit from a professional application by your dentist using a highly concentrated varnish.

  2. fluoride effects on our teeth

  3. CCP-ACP: This stands for casein phosphopeptide-amorphous calcium phosphate. It's a protein that can help deliver calcium and phosphate minerals to the tooth surface, which are the main components of enamel. CCP-ACP is often found in chewing gum, toothpastes, mouthwashes, and dental creams.

  4. Calcium sodium phosphosilicate (NovaMin): This is another type of mineral that can help remineralize teeth. It works by releasing calcium and phosphate ions when it comes into contact with saliva, which can then be used to rebuild the enamel. NovaMin can be found in certain toothpastes (such as Sensodyne Repair and Protect Deep Repair*) and professional dental varnishes.

It is also important to adjust your diet. Aim for tooth-friendly foods rich in calcium and phosphorus, such as milk and cheese. Also, avoid consuming too many sweet and acidic foods and drinks to keep the acidity in your mouth low and provide the necessary conditions to help your teeth regenerate.

Last but not least, it's essential to remove any plaque and buildup that can prevent minerals from reaching your teeth. This can be done through regular brushing, flossing, and professional dental cleanings.

By taking these steps, you can help reverse the early stages of tooth decay and prevent it from spreading further.

How can tooth decay progress if left untreated?

Tooth decay can start small, but if left untreated, it can quickly progress and cause more significant complications. Here's what can happen:

  • Sensitivity Stage: If left untreated, tooth decay will continue to eat away at the tooth enamel, eventually reaching the dentin. Dentin is much softer and more porous than enamel, which can cause sensitivity to hot and cold temperatures, as well as sweet or acidic foods. Also, the white or brown demineralization spots will turn into dark holes, accumulating more plaque.

  • Severe Toothache: If the enamel decay continues to progress, it can reach the nerves inside the tooth. This can lead to a severe toothache, as well as pain when biting down or applying pressure to the tooth.

  • Infection and Abscess: If the decay is still left untreated, the infection can spread deeper and eventually lead to an abscess. This is a serious condition that can cause swelling, pus, and even fever.

  1. Treatment of orthodontic white spot lesions with a remineralizing dentifrice https://europepmc.org/article/med/10686860
  2. CPP-ACP and CPP-ACFP versus fluoride varnish in remineralisation of early caries lesions. A prospective study https://pubmed.ncbi.nlm.nih.gov/26418918/
  3. Oral health https://www.who.int/news-room/fact-sheets/detail/oral-health
  4. Remineralizing Effect of NovaMin and Nano-hydroxyapatite Toothpastes on Initial Enamel Carious Lesions in Primary Teeth https://ejhm.journals.ekb.eg/article_264530_0c7564903eaf9b7c238cfe21dfa08130.pdf