Cavities, which dentists sometimes call dental caries, are spots of tooth decay. They can range in size from tiny to large enough to break teeth.

In 2011–2012, 91% of adults in the United States had cavities, yet many did not know it. This is because cavities do not typically hurt until they get deep enough into the tooth to affect the nerve below.

Learn more about cavity pain in this article, as well as how to get relief.

Symptoms

a woman experiencing cavity pain while she eats an ice lolly
A person with cavity pain may experience tooth sensitivity.

Cavity pain can range from mild to unbearable. When a cavity eats away at the enamel of a tooth, a person might find that it is more sensitive, especially when brushing the teeth or drinking hot or cold beverages.

Cavities that cause deeper damage in the tooth can affect the nerve, causing intense pain.

Sometimes, cavities can grow so large that bacteria can get into the gums, or even the bone underneath the teeth. This can cause intense, unrelenting pain, as well as serious infections.

Some symptoms a person might notice if they have a mild-to-moderate cavity include:

  • tooth sensitivity, which may feel like a stinging or burning sensation
  • occasional toothaches that go away with pain medication
  • sensitivity on one side of the mouth, especially when chewing hard foods
  • discoloration of the teeth, such as yellow, white, or brown spots

When a cavity grows very large or causes a tooth abscess, some symptoms may include:

  • intense pain that may affect just a single tooth
  • a vague but unrelenting ache
  • pain that ranges from throbbing and stinging to pounding or burning
  • swelling in the gums or face
  • nausea
  • a fever
  • pain in the jaw, ears, or gums
  • tooth pain severe enough to interfere with sleeping or daily activities

Sometimes, an abscessed tooth stops hurting for a period of time when the infection kills the nerve or the pulp of the tooth.

However, a person may still have other symptoms, such as swelling, and the pain may return if the infection reaches the gums or bone.

Causes

Bacteria that eat sugar live on the teeth. A person is likely to have more bacteria in their mouth when they eat a very sugary diet, do not brush their teeth, or do not seek regular dental care.

Over time, these bacteria can eat into the enamel of the teeth, eventually causing decay deep in the tooth.

These bacteria form biofilms that cause plaque, making them more difficult to remove. Over time, the bacteria damage the sensitive pulp and nerve of the tooth, causing cavity pain.

Many factors can influence a person’s susceptibility to cavities, including their individual microbiome. The microbiome is a person’s unique colony of bacteria and other microoranisms that can either help or hinder the growth of harmful bacteria in the mouth.

Research also suggests that the bacteria that cause cavities are contagious. A person can transmit cavity-causing bacteria to another person by kissing them, sharing food or drinks with them, or sneezing on or near them.

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How to Get Immediate Relief

Some strategies that can help with cavity pain include:

  • Applying numbing gels: Some over-the-counter (OTC) gels can temporarily soothe tooth pain.
  • Trying warm saltwater rinses: Warm salt water can help kill bacteria and may temporarily ease pain.
  • Trying clove oil: Clove oil may help ease dental pain. Some dental numbing gels use clove oil.
  • Taking OTC pain medications: Pain relievers such as ibuprofen and acetaminophen can help soothe painful symptoms.
  • Trying cold or heat therapy: A person can try applying a cold or hot pack to the outside of their mouth. Alternating these therapies may also help.
  • Ensuring better oral care: Brushing or flossing can remove some of the plaque. This will not cure the cavity, but it can reduce the rate at which bacteria eat into the tooth, potentially preventing the pain from getting worse.

Treatment

Tooth decay severe enough to cause pain warrants a trip to the dentist.

In some cases, there might be a non-cavity cause, such as a sinus infection or problems with the temporomandibular joint.

Only a dentist can diagnose the cause, however, so it is vital to seek prompt treatment to prevent the problem from getting worse.

Treatment depends on the severity of the cavity and where it is in the mouth. Some treatment options may include:

  • Dental fillings: A dentist will drill out the cavity and then fill it with a safe substance to keep out bacteria.
  • Root canals: Root canals can save a dying tooth.
  • Crowns: A crown removes the outer layer of the tooth, eliminates the decay, and then uses a permanent cap to cover the entire tooth.
  • Antibiotics: When a person has a serious dental infection, they may need antibiotics. People with weakened immune systems, those with a history of organ transplants, and those undergoing chemotherapy may also require antibiotics.
  • Orthodontic care: Sometimes, crowded teeth or problems with the bite can increase the risk of cavities. Seeking orthodontic care, such as braces, may help.

When to see a dentist 

A person should schedule an appointment with a dentist for any tooth or mouth pain. If the pain is intense or unbearable, they may wish to contact an emergency dentist.

A person may need emergency care if they cannot get an appointment within the next 24 hours and have any of the following symptoms:

  • a fever
  • physical sickness
  • a headache
  • swelling in the face or around the mouth
  • swelling behind the ears
  • pain so severe that it makes sleeping impossible

A person should seek urgent care for these symptoms, as they may mean that the infection has spread to another area of the body.

Summary

Although cavity pain can be intense, it is highly treatable. A dentist can usually treat the pain within a few hours, either by addressing the underlying cause or by prescribing pain medication while planning for additional treatment.

A person can also try home remedies to ease the pain before they see a dentist.

Very rarely, cavities can cause serious health problems, including widespread infections.

Although there is no need to panic at the first sign of a cavity, avoiding dental care can undermine overall health.