Signs and symptoms of Tooth Decay
Tooth Decay

Tooth Decay Symptoms

Tooth decay is a destructive disease that affects the structure of teeth but in most cases it is a slowly progressing disease. Therefore the symptoms of tooth decay may vary depending on the specific stages of tooth decay that the disease has progressed.

Signs and symptoms of Tooth Decay

Most patients recognise the symptoms of dental caries only in the advanced stages of tooth decay. But some early signs of the disease can help us or our dentist to identify possible areas of decay and treat them before they become dental cavities and cause significant damage to our teeth.

White spots on teeth - Early sign of tooth decay

In the initial phase of the tooth decay process, the acids produced by plaque bacteria cause loss of minerals from teeth. Calcium is the main component of teeth. At the early stage of demineralization there might be no visible evidence of the process unless we check the tooth’s surface at microscopic level.

If demineralization continues, the tooth’s enamel appearance starts to change due to the changes in its mineral composition. This is actually the initial sign of tooth decay, called a ‘white spot lesion’, because the color of tooth enamel changes to an opaque whitish color in the area where the demineralization has caused significant changes in the tooth structure.

A ‘white spot’ is an area where the enamel has lost part of its minerals causing the discoloration. If tooth decay is diagnosed in this phase, the damage is reversible with treatments that enhance the re-mineralization process restoring the tooth enamel.(Read how to reverse tooth decay)

Note: there is another condition that can cause similar white spots on teeth. The condition, called fluorosis, is caused by excess uptake of fluoride, especially affecting children in the first years of childhood. Fluorosis like demineralization also causes changes in the composition of the enamel altering its color, but your dentist can identify which is the underlying condition.

As the demineralization continues, a hole will be created in this spot forming a dental cavity. The patient may experience the following symptoms of tooth decay:

Tooth sensitivity

Tooth sensitivity usually becomes a symptom of tooth decay when the dental cavity has already penetrated through the enamel and has reached the dentine, the softer inner part of the tooth. Eating sweet, sour, hot or cold foods and drinks results in a sharp pain that should alert the patient to visit the dentist. Sensitive teeth is a common tooth decay symptom, but it may also be a symptom of tooth abrasion or gum recession.


If the affected area is in the front area of teeth, it might also be easy to visually detect the decayed area. When the disease progresses, the initial white spot turns to a dark spot as bacteria enter the cavity and decompose the tooth’s structures. However, in many cases cavities develop at the interproximal areas between the teeth where it is difficult for us to detect them (but not for our dentist).


Toothache is a tooth decay symptom experienced when the damage has reached to the live part of the tooth, the pulp, that contains nerves and the blood vessels that feed the tooth. Initially the patient will experience pain occasionally when biting hard, but as the infection continues in the pulp the pain becomes more often and intense.

Continuous sharp tooth pain that does not go away is a clear sign of dental caries, and visiting the dentist immediately is necessary.

Toothache that keeps you awake at night is a symptom of advanced tooth decay. The infected tooth will usually require root canal treatment before it is restored.

Tooth abscess

When the pulp chamber gets infected, the living tissues of the pulp start to die forming pus and creating what is called a ‘tooth abscess’. An intense throbbing pain and swelling are the usual signs of a tooth abscess. At this stage of tooth decay there is increased risk of loosing the tooth unless the infection is treated immediately with ‘root canal treatment’.

Tooth decay is not a condition that can be detected easily in its early stages by anyone with self-examination. Only your dentist can detect the early symptoms of tooth decay before it causes irreversible damage to your teeth that requires dental restoration.

  next page -> Stages of Tooth Decay
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