Tooth Decay vs. Inflammation: Different Pathologies

Dental caries (tooth decay) and inflammation are distinct processes, though they can coexist.

Tooth Decay (Caries)

• Process: Bacterial metabolism of dietary sugars → organic acids → demineralization of enamel/dentin → cavitation.
• Key features: Progressive, often painless until deep; no cardinal signs of inflammation (rubor, calor, tumor, dolor) in the hard tissue itself.
• Stages: White spot (reversible) → enamel caries → dentin caries → pulp involvement.

Inflammation (Pulpitis, Gingivitis, Periodontitis)

• Pulpitis: Bacterial invasion of pulp → inflammatory response (vasodilation, immune cells, pressure) → severe pain (irreversible).
• Gingivitis: Plaque-induced gingival inflammation – redness, swelling, bleeding.
• Periodontitis: Inflammation extends to periodontal ligament/bone → attachment loss.

Relationship

• Caries can lead to pulpitis (inflammation) if untreated.
• Periodontitis involves inflammation of supporting tissues, not the tooth mineral itself.
• Decayed tooth structure is necrotic/degraded, not inflamed.

Accurate terminology guides appropriate treatment: restoration (caries) vs. endodontics/periodontics (inflammation).