Cavities, or tooth decay, are damaged areas in the hard surface of your teeth that develop into holes. These holes are caused by acids produced by bacteria in plaque, a sticky film on your teeth. The sensations associated with a cavity can vary significantly depending on its size and location within the mouth.
How Cavity Sensations Evolve
Initially, a small cavity may not cause noticeable symptoms, as decay is in the outer enamel. As decay progresses deeper into the tooth, reaching the dentin layer, sensitivity often develops. This sensitivity appears as a fleeting, sharp pain or discomfort when consuming hot, cold, or sweet foods and beverages. The dentin contains microscopic tubules that connect to the tooth’s pulp, which houses nerves, making it responsive.
As the cavity enlarges and approaches the pulp, pain can become more persistent and pronounced. This can be a dull ache that lingers even after the stimulus is removed. A sharp jolt of pain can also occur when biting down or chewing, especially on a chewing surface. Visible signs, such as brown, black, or white stains on the tooth, or a noticeable hole, may also appear at this stage.
When decay reaches the pulp, where nerves and blood vessels are, symptoms become more severe. This can lead to spontaneous pain without an obvious trigger, or a constant, throbbing toothache. The pulp can become inflamed, known as pulpitis, causing severe discomfort that may worsen at night or when lying down. In advanced cases, an infection (abscess) can form, leading to swelling, pus around the tooth, and fever, indicating a widespread issue.
Feelings That Might Not Be Cavities
Other oral conditions can produce sensations similar to those of a cavity, making self-diagnosis challenging. Gum disease, like gingivitis and periodontitis, can cause gum tenderness, bleeding, and tooth sensitivity due to exposed tooth roots. Unlike cavity pain, gum disease often involves generalized soreness and inflammation of the gums, not localized tooth pain from specific stimuli. Tooth grinding, or bruxism, can lead to widespread tooth sensitivity, jaw pain, and flattened chewing surfaces, mistaken for cavity pain. The pain from bruxism occurs in multiple teeth and is often worse upon waking.
A cracked tooth, without a cavity, can cause sharp, unpredictable pain when chewing or when exposed to temperature changes. This pain can be intermittent and difficult to pinpoint to a single tooth. Exposed tooth roots, from gum recession, can lead to heightened sensitivity to cold, hot, or sweet stimuli as enamel is absent. Sinus infections can also cause referred pain in the upper back teeth, which might feel like a toothache. This pain often accompanies nasal congestion, facial pressure, and is felt in multiple teeth on one side of the face.
When Professional Help Is Needed
Seeking professional dental care is needed for persistent or worsening oral sensations. Tooth pain that does not subside, sensitivity that lingers after exposure to hot, cold, or sweet items, or discomfort when biting warrants examination. Visible holes, pits, or discoloration on a tooth also indicate a professional assessment is needed.
Delaying treatment for suspected cavities or other issues can lead to more extensive problems. Untreated cavities can progress, resulting in more severe pain, infection, and tooth loss. Prompt dental intervention can prevent complications, alleviate discomfort, and maintain oral health.