The evolution of dental caries in the primary teeth is similar in the permanent teeth, however at a faster rate. Getting started of carious lesions is a white mark on the enamel surface. Without treatment, it will continue to destroy the enamel layer (enamel caries), then the dentin layer which will develop faster than enamel caries and caries will spread.
1st phase: The enamel is attacked and destroyed by acid, the enamel surface has white spots then turned black. Enamel caries has no sensation and painless.
2nd phase: The dentin is destroyed, the child will feel sensitive when eating cold and sour food.
3rd phase: If the tooth has a deep hole without filling immediately, the caries progresses to the root canal, the feeling of pain becomes even more sensitive. At this stage, if your child has a bad toothache, it called acute pulpitis.
4th phase: If the pulpitis have not treated (root canal treatment), the pulp has been dead, rotted and infected. It have entered the jaw and can create pus that causes abscesses in the root of the tooth, Cellulitis and can cause inflammation of jaw.