It has to progress to death. The tooth just doesn't fall over and die tho. Pain is a marker that something is wrong, I'd hope there's a little pain so you can fix it before there's dead tooth.
As a kid I had a lot of bad experiences with dentists which makes me never want to go to one. I'm just amazed my teeth aren't as bad as hers, guess it's just that I don't drink soda usually and even at my worst neet phase I wasn't quite as down bad.
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