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Tooth Decay

A few hours after brushing, bacteria and food particles form plaque on the surface of your teeth. These bacteria produce an acid that erodes the calcium in the tooth's enamel and leads to the formation of minute cavities. If left untreated, the acid will eventually eat through the tooth enamel, and begin eroding the dentin beneath it. This is the best time to repair a tooth. The repair may not even need anesthesia .

Because the dentin is less dense it disolves much faster than overlaying enamel; so, a large cavity could be forming inside the tooth without showing visible signs externally.

As the decay continues, bacteria migrate through the porous dentin and infect the pulp. When your body launches an immune response to the infection, the blood vessels around the tooth enlarge and press against the nerves entering the tooth causing the tooth to ache.

If the infection proceeds and a significant amount of bacteria invades the pulp, then the tooth and nerve may die. This will stop the pain; however, since the body is still fighting the infection, an abscess may form.

A tooth abcess forms around the tip of the tooth's root. This will cause the tooth to ache constantly, and be extremely painful to chew on. If the abscess is left untreated, it will begin to erode the bone around the tooth, and may lead to the formation of a small fistula, or canal, through the bone and its overlaying gum. Just before the fistula reaches the surface of the gum, a swelling, or boil may form. This can persist, or burst releasing foul tasting pus into the mouth.

Risks:
Tooth decay usually does not pose a serious health risk if treated early; however, if the decay is allowed to progress, the tooth will likely die, and the spreading infection may result in general blood poisoning, fever, swelling in the face and neck, and a general feeling of unwellness.

Treatment:
Self Help: The best treatment is preventative. Through proper brushing, flossing, and dental visits, the chances of significant dental decay are greatly reduced. Sealants can also be used as a good preventative measure.

Professional Help:
In the early stages, a dentist can treat the tooth decay by cleaning and filling the cavity. More advanced tooth decay may require the dentist to perform an internal cleansing. If an abcess has formed then an apicectomy may also be necessary. This is a surgical procedure in which the infected tissue at the base of the root is removed. If the tooth and underlying bone is severely decayed, then the tooth may need to be extracted.

Hard to believe this tooth has such large internal decay. Like the old man said,
"You can't tell how deep a well is by lookin' at the top."