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Rotten teeth and tooth decay: stages and treatment

If you let your dental care lapse, you may experience rotting teeth.

Most people are more familiar with the term “tooth decay” when describing badly decayed or rotten teeth.1 It might be embarrassing to think about, and while you can’t undo the damage already done, it is possible to improve the condition of teeth that have begun to fall into disrepair. Failing to do so can lead to dental pain, cavities, and even a loss of your permanent teeth as they fall out because of the decay. Plus, from an appearance standpoint, tooth decay can look unsightly and could affect other aspects of your life, such as your job and your relationships.

Stages of rotten teeth and tooth decay

Although difficult to think about, preventing tooth decay is easier than it sounds. For one thing, there are various stages of tooth decay2 to watch out for, so if you have concerns about rotten teeth, look for these signs of tooth decay: 

  • Stage 1: White spots on teeth - If you notice white spots starting to form on your teeth, this may be one of the first signs of the presence of tooth decay. This occurs when calcium is lost and plaque builds up on the teeth and gums. The plaque begins to form an acid that eats away at tooth enamel, causing the spots. With proper treatment, such as using fluoride toothpaste, you may be able to undo the damage of tooth decay and prevent it from getting worse.
  • Stage 2: Decaying enamel - If measures aren’t put into place to treat and prevent tooth decay beyond the appearance of white spots on teeth, the next stage of tooth decay that occurs is the erosion of dental enamel. If enamel wears away from a tooth, there is no natural way to replenish it. Improved dental habits are the only way to keep tooth decay from further damaging the tooth. 
  • Stage 3: Decaying dentin - At this stage, tooth decay has become severe since dentin, which is the layer of the tooth between the enamel and the pulp, has become damaged. Once the dentin begins to decay, you may experience more intense pain since the next layer, the pulp, is the tooth’s center and contains the living tissue of the tooth. It’s possible for a cavity to form at this stage, and a dental filling will be needed to restore the tooth. 
  • Stage 4: Pulp damage and infection - If tooth decay continues beyond the dentin, the pulp of the tooth can become infected and cause pus to build up which kills off the tooth’s nerves and blood vessels. Drastic measures from here may include a root canal from keeping you from losing the tooth altogether. 
  • Stage 5: Abscess forms - During this stage, serious damage has occurred and a tooth abscess, which is a pocket of pus inside of the tooth, may form. An abscess may be present if you experience pain, but you may also notice a foul smell or fever. If severe enough, an infection may occur in the adjoining bones. Other symptoms, such as swelling in the mouth, may arise as well. Oral surgery is necessary at this stage to treat the abscess and underlying infection, along with relieving tooth pain.
  • Stage 6: Tooth loss occurs - Without treatment, the tooth may “die off” and become blackened because of the infection and decay. A tooth extraction will be necessary to remove the dead tooth, and a dentist may recommend a bridge or a crown to restore the appearance once the area has fully healed.

Rotten teeth and tooth decay treatment

If you are just beginning to experience tooth decay and want to take better care of your teeth, the time to start is now. Making a regular habit of brushing and flossing when you see early signs of decay, such as white spots on the teeth or worn away enamel, can prevent larger, more painful problems later.

Some people are more prone to cavities, and for them, tooth decay may feel inevitable and unavoidable. They may think, “What is the point of preventing rotting teeth if I already know they will eventually fall out?” However, taking steps today can keep your teeth healthy tomorrow and farther into the future.

Talk to your dentist about treating your existing tooth decay. He or she may have a good idea of what stage of tooth decay you have and what to do today to treat it.

How to prevent rotten teeth and tooth decay

If you have concerns about rotten teeth, you can begin to improve existing habits and start new ones to improve your oral health. Some regular habits you can start now to prevent tooth decay3 include:

  • Brushing twice a day with a fluoride toothpaste
  • Flossing twice a day
  • Drinking fluoridated water
  • Limit sugary foods such as candy and cookies
  • Limit drinking sugary drinks such as soda or juice
  • When drinking, use a straw to limit contact between sugary drinks and your teeth
  • Talk to your dentist about sealants that can protect the teeth 
  • Continue to visit the dentist regularly  

Use dental insurance to prevent rotten teeth

A dental insurance plan helps to reduce stress when thinking about how much your tooth decay has progressed and what kinds of measures you may need to take to prevent rotten teeth. When you enroll in dental insurance, you can use your benefits to regularly visit the dentist. 

If you have more advanced tooth decay, your insurance can help cover some of the cost of fillings or root canals. 

A dentist is your partner in health, so use your benefits to keep your teeth healthy and stave off tooth decay! And if you don’t have dental insurance yet, shop around and enroll in a plan that works for you.


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1. (Last accessed December 2019)
2. (Last accessed December 2019)
3. (Last accessed December 2019)

Brought to you by The Guardian Life Insurance Company of America (Guardian), New York, NY. Material discussed is meant for general illustration and/or informational purposes only and it is not to be construed as tax, legal, investment or medical advice.

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