Editing Tooth decay (section)

==Signs and symptoms==
[[File:ToothMontage3.jpg|thumb|right|alt=Montage of four pictures: three photographs and one radiograph of the same tooth.|'''(A)''' A small spot of decay visible on the surface of a tooth. '''(B)''' The radiograph reveals an extensive region of demineralization within the dentin (arrows). '''(C)''' A hole is discovered on the side of the tooth at the beginning of decay removal. '''(D)''' All decay removed; ready for a [[dental restoration|filling]].]]
A person experiencing caries may not be aware of the disease.<ref>[http://www.hpb.gov.sg/hpb/default.asp?pg_id=865&aid=198 Health Promotion Board: Dental Caries] {{Webarchive|url=https://web.archive.org/web/20100901014808/http://www.hpb.gov.sg/hpb/default.asp?pg_id=865&aid=198 |date=2010-09-01 }}, affiliated with the Singapore government. Page accessed August 14, 2006.</ref> The earliest sign of a new carious [[lesion]] is the appearance of a chalky white spot on the surface of the tooth, indicating an area of [[Demineralization (physiology)|demineralization of enamel]]. This is referred to as a white spot lesion, an incipient carious lesion, or a "micro-cavity".<ref name="NYT">{{cite news|title=A Closer Look at Teeth May Mean More Fillings|url=https://www.nytimes.com/2011/11/29/health/a-closer-look-at-teeth-may-mean-more-fillings-by-dentists.html|access-date=November 30, 2011|newspaper=The New York Times|date=November 28, 2011|author=Richie S. King|quote=An incipient carious lesion is the initial stage of structural damage to the enamel, usually caused by a bacterial infection that produces tooth-dissolving acid.|url-status=live|archive-url=https://web.archive.org/web/20111129223056/http://www.nytimes.com//2011/11/29/health/a-closer-look-at-teeth-may-mean-more-fillings-by-dentists.html|archive-date=November 29, 2011}}</ref> As the lesion continues to demineralize, it can turn brown but will eventually turn into a cavitation ("cavity").  Before the cavity forms, the process is reversible, but once a cavity forms, the lost tooth structure cannot be [[Regeneration (biology)|regenerated]].
A lesion that appears dark brown and shiny suggests dental caries were once present, but the demineralization process has stopped, leaving a stain. Active decay is lighter in color and dull in appearance.<ref>Johnson, Clarke. "[http://www.uic.edu/classes/orla/orla312/BHDTwo.html Biology of the Human Dentition] {{webarchive|url=https://web.archive.org/web/20151030052831/http://www.uic.edu/classes/orla/orla312/BHDTwo.html |date=2015-10-30 }}." Page accessed July 18, 2007.</ref>

As the [[Enamel organ|enamel]] and [[dentin]] are destroyed, the cavity becomes more noticeable. The affected areas of the tooth change color and become soft to the touch. Once the decay passes through the enamel, the [[dentinal tubules]], which have passages to the nerve of the tooth, become exposed, resulting in pain that can be transient, temporarily worsening with exposure to heat, cold, or sweet foods and drinks.<ref name="medline">{{MedlinePlusEncyclopedia|001055|Dental Cavities}}</ref> A tooth weakened by extensive internal decay can sometimes suddenly [[Bone fracture|fracture]] under normal chewing forces. When the decay has progressed enough to allow the bacteria to overwhelm the pulp tissue in the center of the tooth, a [[toothache]] can result, and the pain will become more constant. Death of the pulp tissue and infection are common consequences. The tooth will no longer be sensitive to hot or cold but can be very tender to pressure.

Dental caries can also cause [[halitosis|bad breath]] and foul tastes.<ref>[https://web.archive.org/web/20180630212354/http://www.med.nyu.edu/patientcare/patients/library/article.html%3FChunkIID%3D11496 Tooth Decay], hosted on the [[NYU Langone Medical Center|New York University Medical Center]] website. Page accessed August 14, 2006.</ref> In highly progressed cases, an infection can spread from the tooth to the surrounding [[soft tissue]]s. Complications such as [[cavernous sinus thrombosis]] and [[Ludwig's angina|Ludwig angina]] can be life-threatening.<ref>[http://www.webmd.com/a-to-z-guides/cavernous-sinus-thrombosis Cavernous Sinus Thrombosis] {{webarchive|url=https://web.archive.org/web/20080527163130/http://www.webmd.com/a-to-z-guides/cavernous-sinus-thrombosis |date=2008-05-27 }}, hosted on WebMD. Page accessed May 25, 2008.</ref><ref>{{MedlinePlusEncyclopedia|001047|Ludwig's Anigna}}</ref><ref>Hartmann, Richard W. [http://www.aafp.org/afp/990700ap/109.html Ludwig's Angina in Children] {{webarchive|url=https://web.archive.org/web/20080709045030/http://www.aafp.org/afp/990700ap/109.html |date=2008-07-09 }}, hosted on the American Academy of Family Physicians website. Page accessed May 25, 2008.</ref>