How Long Does It Take For A Cavity To Hurt?

Tooth Pain

Should you wait till your tooth hurts?

Most people are amazed to learn that cavities start as microscopic pits. They result from an acidic imbalance in the normal chemistry around the enamel layer of a tooth. When the tooth is attacked by acid (usually produced by germs that live in the mouth) the surface layer dissolves. Gradually the tiny pit grows larger and larger until it finally reaches the soft inner part of the tooth called dentin.

This dissolving process can take many years, or sometimes may seem to happen almost overnight. Some times very small cavities are very sensitive, and some very large cavities are not at all. In either case, when the germs causing the cavity reach the far inside of the tooth (commonly called the ‘nerve’ or ‘pulp’), then an infection sets in which can spread to the jaw, or the face, or sometimes the lungs or the brain. (I spoke to some one last week who had part of her lung surgically removed because of bacterial infection that spread from her mouth.)

So, strangely, small cavities or large cavities sometimes hurt and sometimes don’t hurt at all. Sometimes patients come in with a large infection that has caused a remarkably big hole in their jaw bone that shows on their digital x ray, and the patient is not even aware that the infection or the hole is there. We look at the digital x ray together and they usually say “I don’t even feel it”. Usually though, an infection in the nerve is painful and obvious.

Most people prefer to fix smaller cavities early before they hurt or spread. Most people that do this keep their teeth longer with fewer problems than people who like to “wait until it hurts”. Since silver fillings are not very good for easily treating the smallest cavities, in the old days, before modern dentistry, dentists would wait, or ‘watch’ cavities while they grew. Nowadays, tooth colored bonded fillings can fix cavities that are so small they are barely visible, so there is no longer a reason to watch them grow larger. When fixed, they’re now completely invisible.

For further information on keeping your mouth healthy and pain free, call Dr. Korwin’s Red Bank, Middletown NJ Dental office for an appointment at 732-219-8900 or fill in our appointment form.