Untreated dental caries, commonly known as cavities, represent the ongoing destruction of tooth structure by bacteria. This progressive decay will not resolve spontaneously, meaning a delay in treatment guarantees worsening outcomes for the tooth and the entire body. The initial damage is only the beginning of a chain reaction that can affect surrounding tissues and distant organs.
The Progression from Enamel to Dentin
The earliest stage of decay involves the enamel, the tooth’s hard outer layer. Bacteria in plaque convert dietary sugars into acid, which dissolves the mineral content of the enamel in a process called demineralization. At this point, the decay may appear as a white or chalky spot, and the damage can often be reversed with professional fluoride treatments and improved oral hygiene.
If the decay is not addressed, it penetrates the enamel and reaches the dentin, the softer, yellowish tissue underneath. Dentin is less dense than enamel, causing the decay to accelerate once it reaches this layer. This is the stage where individuals typically start experiencing noticeable symptoms, primarily increased tooth sensitivity.
The dentin contains microscopic tubules that lead directly to the tooth’s nerve center. When decay reaches here, the tooth may feel a sharp, short-lived pain when exposed to hot, cold, or sweet stimuli. At this point, a simple dental filling is usually the most viable treatment to remove the decay and restore the tooth’s structure.
Infection Reaching the Nerve Center
Failure to treat the decay in the dentin allows the bacterial infection to burrow further inward, eventually reaching the pulp. The pulp is a soft tissue located in the center of the tooth, containing nerves, blood vessels, and connective tissue. The resulting inflammation is known as pulpitis.
As the infection progresses, the pain changes from simple sensitivity to spontaneous, severe, throbbing pain that may last for minutes or more, even after the stimulus is removed. This continuous inflammation inside the rigid tooth structure compromises blood circulation to the pulp tissue. If the infection is left unchecked, the lack of oxygen and nutrients leads to pulp necrosis, or nerve tissue death.
Once the nerve tissue dies, the acute pain may temporarily stop, creating the false impression that the problem has resolved. However, the dead tissue and bacteria remain, and the infection continues to spread down the root canal. At this stage, a standard filling is no longer sufficient, and treatment shifts to either a root canal procedure to remove the infected pulp or a complete tooth extraction.
Abscess Formation and Jawbone Damage
When the infection moves beyond the tip of the tooth’s root (apex), it enters the surrounding bone and soft tissue, leading to the formation of a dental abscess. An abscess is a localized pocket of pus, which is a collection of dead white blood cells, tissue debris, and bacteria. Physical symptoms can include localized swelling, persistent pain, a fever, and sometimes a foul taste in the mouth if the abscess drains.
The chronic presence of this infection and inflammation can cause damage to the jawbone itself. The pressure from the swelling begins to erode the bone tissue surrounding the tooth’s root, which can lead to localized bone loss. In severe cases, the infection can progress to osteomyelitis, which is a dangerous infection of the bone, compromising the stability of the affected tooth and potentially adjacent teeth.
The danger intensifies if the infection spreads rapidly into the facial or neck spaces, a condition known as cellulitis. A particularly risky form is Ludwig’s Angina, which affects the floor of the mouth and can cause swelling severe enough to compromise the airway, requiring emergency medical intervention.
Potential Impact on Overall Health
The consequences of an untreated dental infection are not limited to the mouth and jaw; the bacteria can enter the bloodstream and affect distant organs. This link between oral infection and systemic conditions is an established area of health concern. Chronic inflammation in the mouth contributes to the overall inflammatory burden on the body.
Specific bacteria from the mouth can travel through the bloodstream, potentially contributing to the formation of arterial plaque, which increases the risk of heart attack and stroke. Untreated dental infections have been linked to endocarditis, an infection of the heart’s inner lining, which occurs when bacteria attach to damaged heart tissue.
For individuals with pre-existing conditions like diabetes, chronic oral infections can make blood sugar levels more difficult to control, creating a challenging cycle. Research suggests that untreated infections during pregnancy may also be associated with complications such as preterm birth and low birth weight.