If you visit your dentist regularly, they can check your teeth for cavities. These twice-annual checkups should be sufficient to catch cavities before they cause problems. However, if you don’t make it to the dentist as often as you should, or if you’re concerned about the health of your teeth between visits, you might wonder if you have cavities. Pain could be a sign that you have cavities, but it might not.
Understanding cavities and why they might or might not cause pain can help you decide whether you should see your dentist.
What Are Cavities?
Cavities, also called tooth decay or dental caries, are literally holes in your teeth. These holes are caused by some types of oral bacteria that live in your mouth. These bacteria feed on sugars and starches in the foods and beverages you consume. As they eat these carbohydrates, they produce acid.
The acid attacks your tooth enamel, which is very strong against stress and abrasion, but is relatively weak against acid. The acid initially removes minerals from the tooth enamel, but if there’s enough of it and it stays in contact with your teeth long enough, it starts to produce holes in your teeth–cavities.
Cavities are one of the most common medical conditions in the world. In the US, about 96% of adults will develop cavities at some point in their lives.
Why Do Cavities Hurt?
Whether you feel cavity pain is somewhat complicated. Unlike the rest of your body, your teeth don’t have skin, and therefore they don’t have nerves on the surface. Instead, the tooth nerves are actually inside the teeth. In healthy teeth, they perform a pretty limited function, mostly sensing whether your teeth are getting pressure on them and whether you shouldn’t bite down so hard.
However, your teeth can get sensitive if they develop cavities. A cavity reduces the amount of insulation around the tooth nerve, which can make them sensitive to hot and cold foods. Your teeth could also be sensitive to sugary drinks and foods. If cavities reach a certain point, acid produced by bacteria can penetrate the tooth and irritate the nerve.
Left untreated for long enough, cavities can actually reach the tooth nerve inside the pulp chamber. This is called an infected or abscessed tooth, and you’re more likely to experience spontaneous, severe, and lasting pain. But not always–sometimes your tooth might be infected without actually starting to hurt. That’s because your tooth nerve is mostly sensitive to pressure, caused by the growing numbers of bacteria inside the tooth, but sometimes the tooth can drain so that no pressure builds up on the nerve. Root canal therapy can provide pain relief in this case.
Sometimes, too, the infection could kill the tooth nerve. Then you might not feel any pain until it begins to attack your bone or other teeth that still have living nerves.
What Else Could Be Causing Tooth Pain?
Not all tooth pain is caused by cavities. There are many potential causes for sensitive teeth. Some common causes include:
- Gum disease
- Imbalanced bite
- Chipped or cracked teeth
- Eroded enamel
Gum disease affects about half of all adults in the US. It’s the leading cause of tooth loss, and it can cause your gums to separate from your teeth. This creates spaces where hot or cold foods and beverages can slip in and contact the tooth root. The tooth root is made of cementum, which is more sensitive than the tooth enamel. Sensitivity might affect several teeth close together where you have receding gums.
Imbalanced bite can put excessive pressure on one or more teeth. Remember, the tooth is designed to sense pressure, so this can contribute to sensitivity. You might notice sensitivity after chewing, clenching your teeth, or in the morning (after clenching your teeth during sleep).
Chipped or cracked teeth can also expose your teeth to sensitivity. A minor chip can remove insulating enamel, so you notice sensitivity to heat and cold. A more serious crack can actually expose the tooth nerve, making sensitivity much worse and exposing you to the risk of infection.
Enamel erosion is caused by frequently consuming acidic drinks, like soda, fruit juices, or wine. This strips the enamel from your teeth generally, so there’s less insulation all around. You might notice sensitivity in multiple teeth at the same time.
How to Prevent Cavities
There are several steps you can take if you don’t want your dentist to find a large number of cavities at your next appointment. You can prevent cavities by:
- Watching what you eat
- Brushing and flossing
- Make regular dental visits
Oral bacteria feed on the foods you choose to eat. If you choose different foods, you can reduce the ability of oral bacteria to cause cavities. In fact, some oral bacteria actually prevent cavities, if you feed them right.
You should brush your teeth at least twice a day with a fluoride toothpaste. (Find out which toothpaste we recommend here.) Don’t worry about brushing too much more than that, and if you do, perhaps skip the toothpaste. Floss every day. This not only helps prevent cavities on the surfaces your brush can’t reach, it protects you from gum disease.
Most people should see their dentist every six months or so. Sometimes your dentist will tell you you don’t need to visit as often, but other times they’ll say you need to make more regular visits. Your dentist can clean your teeth and provide fluoride treatments to protect your teeth. If you’re overdue for an appointment, call your dentist.