Dental Decay, Periodontal Disease, and How Dental Services Can Help

When it comes to naturally occurring problems that virtually everyone will endure at some point in their life, dental problems are some of the most common, and also some of the most painful. Many factors contribute to the development of these problems, but they usually come down to a combination of genetics and dental hygiene.

In this post, we’ll be outlining the basic stages of both dental decay and periodontal (gum) disease, and which dental services are most appropriate for each stage.

Dental Decay

Stages of Dental DecayAs with almost all dental problems, the main culprit of dental decay is plaque. That is the sticky, fuzzy film that builds up on your teeth when you go long periods of time without brushing. Plaque is acidic. It eats away at the various layers of your teeth. So, why would something that occurs “naturally” in your mouth be harmful? To understand it better, let’s look at how plaque forms.

  1. When you eat food, the carbohydrates in it combine with the bacteria that naturally lives in your mouth.
  2. These two substances combine to form an acid.
  3. That acid collects food particles left over in your mouth from meals, creating a hard, sticky paste.

Considering how plaque forms, it should make sense why foods that are high in sugar contribute to more plaque, and thus more cavities.

Over time, the acid in plaque will begin to eat away at the various layers and tissues that comprise your teeth. Here are the stages of dental decay from beginning to end.


As plaque sits on your teeth, it begins to wear down the enamel. This is the protective outer layer of the tooth, and unlike the lower layers, this one can be restored naturally through proper brushing and flossing and improved diet. A professional dental cleaning will also help reverse the process faster.

If the acidic plaque sits on your teeth for too long, eventually the enamel will begin to get worn away in specific areas, and the acid will reach the next layer of your teeth.

First Stage Tooth Decay

Below the enamel is the dentin, the hard, bony layer of the teeth. This often results in the formation of dark spots on the teeth that many mistake for cavities, when in truth these spots are merely areas where the acid has reached the enamel. At this stage, a professional dental cleaning is important, as well as dramatically improved dental hygiene and diet.

Cavity Formation

Stages of Dental DecayOnce the acid has eaten its way past the dentin, you officially have a cavity. At this stage, you will likely begin to feel some pain, especially when eating sugary, cold, or hot foods.

Unfortunately, cavities can’t be reversed through natural means, and will require a dental filling.


Below the dentin is the tooth pulp. This is soft tissue that contains the tooth root. When the acid makes its way into the tooth pulp, it results in infection and inflammation. The tooth pulp begins to swell, but is suppressed by the surrounding dentin. All of the pressure is thus focused downward onto the root and blood vessels that keep the tooth alive. This results in considerable pain.

Pulpitis can either be reversible or irreversible. The former can usually be solved by a simple dental filling, while the latter will require a root canal.


If pulpitis isn’t taken care of, the infection will only get worse. Ultimately, a pocket of infection will open up somewhere near the tooth root, usually at the gumline. It looks like a pimple on the gums, and is extremely sensitive to touch. At this point, dental pain has probably reached its pinnacle.

A root canal is the most appropriate option for a dental abscess.

Periodontal Disease

Many people have heard periodontal disease referred to simply as “gum disease”. It is also often referred to as “periodontitis” and “gingivitis”. So, which terms are appropriate? Here’s what you need to know.

  • Periodontal disease” refers to a disease of the gums and is synonymous with “gum disease”.
  • Gingivitis is an early stage of periodontal disease. It is an inflammation of the gums that results in pain and easy bleeding. Gingivitis is reversible.
  • Periodontitis is an advanced stage of gingivitis in which the gums begin to recede from the teeth. This results in loose teeth and often in tooth loss. Periodontitis is more difficult to reverse.

Periodontal disease happens as a result of plaque making its way below the gumline. The plaque itself is not responsible for the swelling of the gums. In fact, this is the result of a hormone your body produces in an attempt to fight the plaque. This hormone results in a swelling of the gums, which can make it painful to brush. The gums will also begin to bleed very easily.

If periodontal disease progresses into periodontitis, there are a variety of advanced levels that can be reached, including:

  • Aggressive periodontitis – This is a rapidly progressing form of periodontitis that affects the gingival tissue and gingival ligaments. These are the tissues that hold your teeth in place, and thus the teeth will begin to loosen. Aggressive periodontitis can also wear down the jaw bone.
  • Necrotizing periodontitis – This often affects people with immunosuppression or HIV. Necrotizing periodontitis results from various dental structures being deprived of nourishment that maintains their health. This results in soft tissue necrosis and the rapid degradation of bone tissue.

As with dental decay, plaque is the main factor of origin for periodontal disease, but other factors also increase one’s risk, including:

  • Immuno-Suppressing Systemic Diseases
  • Diabetes
  • Teeth grinding
  • Various medications such as antidepressants, oral contraceptives, and certain heart medications
  • Hormone changes as a result of puberty, pregnancy, or menopause
  • Tobacco use

Treatment for Periodontal Disease

Stages of Dental DecayWhen periodontal disease is in its early stages, it can usually be treated and reversed through basic home remedies such as improved dental hygiene and a healthy change in diet. However, if it is allowed to progress, the pain and bleeding will increase and it will become harder to fight it on your own.

At later stages, it is a wise idea to consult your dentist for more professional and effective periodontal disease treatment. There are a variety of non-surgical options your dentist can likely perform, including scaling and root planing, which will help remove plaque and dangerous toxins that often cluster in pockets as a result of periodontal disease. Host modulation is another possible treatment, which works by changing the bacterial host properties, thus mitigating the level of hospitality to various toxins.

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