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Dental Decay is really a process: Certain bacteria that sit on the tooth surface metabolize sugars and carbohydrates and produce acid. Tooth structure is dissolved by acid. Decay usually starts as an etching of the enamel. Once it has progressed into the underlying dentin, there is no stopping it without removing the soft decay and placing a restoration (filling). Above, the sketches show the most common places for the start of decay:
This is called pit and fissure decay. It occurs in the grooves and pits present in teeth when they come into the mouth.
This is called interproximal decay. It occurs between teeth and can be found early only with x-rays.
This is also interproximal decay but, here, it is shown on front teeth. If this decay is not removed early, it will result in front fillings that can show.
This is called root decay and it occurs on the root surface rather than on the enamel. Root decay is caused by a different bacteria that the others above. It can be insidious and jump from tooth to tooth. Root Decay occurs later in life and can present a serious and hard to control problem.
The Progress of Decay
Sketch A shows early, or incipient, decay on the biting surface groove and between the teeth. At this early stage, decay may become "arrested." This means that sometimes it will stop growing while it is still in the outer enamel surface of the tooth.
Sketch B shows more advanced decay. It has entered the dentin layer that lies beneath the enamel. Now it will grow faster under the enamel. The patient may not know there is decay since most of it is hidden. It will be seen on an x-ray however.
In Sketch C the untreated decay has reached the pulp, or the space in which the nerve lives. The back root of the molar shows an abscess in the bone at the root of the infected tooth. (For more information on abscessed teeth see Abscessed-Teeth. For more information on the root canal that will be needed to save the tooth, see Root Canal.)
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