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What are the symptoms of tooth decay?

There may or may not be symptoms of tooth decay that are evident to a patient. It is important to have an exam by a dentist to diagnose tooth decay. Obvious symptoms are pain and swelling. Usually at these symptoms the tooth is beyond filling and may need a root canal or an extraction. A new hole or new stained area in the tooth could be signs of tooth decay. Sometimes there are no signs or symptoms that are evident to the patient, which is why an exam by a dentist with dental x-rays is necessary to properly diagnose cavities.

Technically speaking, tooth decay is the demineralization or dissolving of tooth structure as a direct result of acids produced by cavity-causing bacteria. The enamel layer on the outside of the tooth is quite thick and acts to insulate and protect the nerve inside the tooth. For this reason, tooth decay can advance "silently" if left untreated.

More often than not, there is no pain or symptoms associated with tooth decay until it gets deep enough into the tooth to impact the nerve indirectly or directly. Symptoms may include the following:
  • Increased sensitivity to hot or cold food/drink
  • Increased sensitivity to sweets
  • Teeth that break or fracture
  • Dull aching or throbbing pain
For this reason, it is important to have regular check-ups with your dentist in order to detect tooth decay while it is small and easy to treat. 
Some symptoms of tooth decay are sensitivity to hot and cold foods or touch. This is a result of another symptom -- your gums receding away from the teeth. That's because this exposes tooth roots to plaque that can then lead to decay.

The best course of diagnosing tooth decay is through routine visits to your dentist.
When decay is small, or incipient, there are few symptoms. As decay penetrates into the dentin, which contains nerve endings, symptoms may develop. A patient may notice sensitivity to cold, or sweet. These symptoms become more pronounced and may turn into pain if the decay is untreated. When decay penetrates the tooth's nerve, or pulp, symptoms may be painful aching or loss of tooth structure. 

Tooth decay does not always have symptoms but when there are symptoms it can include sensitivity or pain to hot, cold, and/or sweet, or just getting food impaction. If the decay is severe enough, some patients feel like there tooth is breaking or an old filling is loose. 

There are several common symptoms of tooth decay. The most common are thermal sensitivity and sensitivity to sweets. The first signs are when eating something hot or cold, you feel sensitive on the tooth with the cavity. This is also seen with candy such as starbursts, sweet tarts, etc. As the decay becomes larger, other symptoms such as dull ache and sensitivity to pressure or biting pressure become present. This often indicates that the decay is close in proximity to the nerve increasing the likelihood of a root canal or extraction. 
Dante A. Gonzales, DMD
Orthodontics & Dentofacial Orthopedics

Tooth decay is a progressive disease and has many different symptoms along the way. 

  • The initial sign of decay is a discoloration of the teeth, usually a chalky white spot will appear, and it can soon turn dark brown or black. This can happen anywhere on the tooth surface, and sometimes occurs between the teeth which is almost impossible to see.
  • As the decay progresses into the tooth, the tooth can become sensitive to hot or cold. In addition, the tooth could become sensitive to sweet foods or drinks. Depending on the depth of the decay, the sensitivity can be mild and last only several seconds to severe, lasting longer much longer.
  • If the decay progresses into the dentin and eventually into the pulp chamber of the tooth, the sensitivity can turn into chronic pain and throbbing
  • And eventually if the decay progresses past the pulp chamber, through the root, and into the bone, the symptoms will most likely include chronic pain, throbbing, and pain upon touching/chewing on the tooth. In addition, there may be swollen lymph nodes in the mouth.
Symptoms of tooth decay include:
  • discomfort
  • tooth pain when eating or drinking something cold or hot
  • pain when chewing
  • pain when eating sweet or salty foods
Tooth pain, especially when it occurs during normal eating or drinking, should be evaluated by a dentist for possible decay.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.