Do cavities hurt?

Do cavities hurt?

Not at first. The NHS says tooth decay may not cause any symptoms at first and that pain usually appears as it gets worse. NIDCR says early decay usually has no symptoms, and Healthline says cavities often cause no symptoms in their early stages. Decay on the outer enamel surface generally does not hurt because enamel has no nerve.

That is why many people find out about a cavity at a checkup, not because of pain. Cleveland Clinic recommends checkups at least twice a year, and dentists can find decay on X-rays before it is visible.

When does a cavity start to hurt?

Pain follows how deep the decay goes. Cleveland Clinic's five stages put sensitivity at the dentin stage, when decay moves faster through the softer layer under the enamel, and pain, gum redness and swelling at the pulp stage. At the abscess stage, untreated infection can cause pain that radiates to the jaw or face, facial swelling and swollen neck lymph nodes.

None of the sources we read says how many weeks or months a cavity takes to start hurting, because it varies with the tooth, your diet, your oral hygiene and the size of the cavity. If a question is how long you can leave it, the safe answer is not to.

What cavity pain feels like

The NHS lists toothache and sharp pain when eating or drinking hot, cold or sweet things. Healthline lists lingering sensitivity to hot, cold or sweet things, pain or pressure when biting, ongoing toothache that can come on suddenly or after eating, and a visible or detectable hole or pit. Holes between teeth or in the grooves may not be visible but can still cause pain or sensitivity.

Do cavities smell?

Not directly. Healthline says a cavity itself does not smell, but the bacteria in the plaque that causes the cavity can produce an odor, often described as sulfur-like, and a cavity may leave a sour or bitter taste that brushing does not remove. The NHS decay page does not mention bad breath or taste.

Persistent bad breath has many other causes, according to Healthline, including dry mouth, gum disease, infections, dentures or braces, smoking, certain foods, sinus problems and reflux, so see a dentist if it does not improve within a few weeks of regular brushing and flossing.

Can cavities or a decayed tooth cause headaches?

Headache is not listed as a typical cavity symptom in the sources we read. Cleveland Clinic lists headaches among the symptoms of impacted wisdom teeth and TMJ disorders, and Healthline's sinus page describes tooth pain from sinus pressure. A headache with a dental problem can also come with infection, so if you have headache with fever, facial swelling or neck stiffness, seek medical care.

How cavities are treated

The NHS and Cleveland Clinic agree on the ladder. Early decay can be treated with fluoride, such as mouthwash, varnish or prescription toothpaste. A hole is usually filled. Decay that reaches the pulp may need root canal treatment, and a tooth that cannot be saved may be extracted. Our guides on fillings and root canals explain what each involves.

Emergency signs

Cleveland Clinic says to go to the nearest emergency room if a tooth abscess comes with a fever of 100.4°F (38°C) or higher, confusion, difficulty swallowing, an elevated heart rate or facial swelling. It also says pain may fade if the pulp dies, but the infection can keep spreading, so a toothache that suddenly stops is not a reason to cancel your appointment.

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