Cavity Pain: Causes, Treatment, Prevention

Pain and discomfort are common symptoms of cavities (holes that form on the teeth). These symptoms often occur due to tooth decay but may also happen because of an abscess, fracture, or repetitive teeth grinding.

Pain that affects your teeth can make eating, sleeping, talking, and daily functioning difficult. Getting treatment isn’t just important for symptom relief. Without treatment, complications like tooth loss and infection can occur.

It’s important to know the parts of the oral cavity (mouth) and the overall structure of your teeth to understand cavity pain. Here’s a breakdown of your mouth’s anatomy:

• Lips: Bands of muscular tissue on the upper and lower exterior (outside) of the mouth that help with eating and articulating speech
• Hard palate: The bony front portion of the roof of the mouth, which separates the roof from the nasal cavity
• Soft palate: The muscular rear portion of the roof of the mouth, which contains the uvula and stops food from blocking the nasal passages when swallowing
• Tongue: Sits on the floor of the mouth, senses taste, and helps with digestion and speaking
• Buccal mucosa: The damp inner lining of the oral cavity
• Teeth: Structures that help you chew, swallow, and speak that are made of enamel, dentin (layer of tissue), and several nerves and blood vessels that connect to your jaw bones

Cavity pain (also known as pulpitis) can present differently based on the severity of your condition and the extent of your tooth damage. Cavity pain in one tooth may affect neighboring teeth as well. Symptoms can range from a dull ache to sharp, searing tooth pain and pressure.

Dentists typically break symptoms into two types of cavity pain:

• Reversible pulpitis: The pain or tooth sensitivity is temporary, doesn’t happen at rest, and is triggered by heat, cold, or pressure
• Irreversible pulpitis: The pain is constant, worsening from changes in temperature and pressure or when you’re lying down

Cavity pain usually happens as bacteria pass through cavities in the enamel of teeth and access the tooth’s pulp. This triggers an inflammatory (immune) response, which activates the nerves there. Tooth decay is the most common cause of this pain, though other dental issues can also initiate symptoms.

Tooth Decay

Your mouth contains bacteria that digest starches and sugars from the foods and drinks you consume. They form acids as a byproduct, which starts to break down the enamel exterior of the teeth, pulling out minerals. Acid, saliva, bacteria, and food content form plaque, a sticky substance that coats the teeth. If you don’t brush or floss properly, the acids in plaque form cavities in the teeth.

Many factors can raise the risk of tooth decay, including:

• Not brushing or flossing regularly
• Eating a diet high in sugars and starchy foods, such as soda and candy
• Smoking tobacco
• Taking certain medications or cancer treatments that can reduce saliva production
• Being of younger age, as infants and toddlers may be at risk during bottle feeding
• Being of older age, as gums start to recede and the chance of cavities forming increases

Tooth Abscess

A tooth abscess is a pocket of pus that forms when a cavity or cracked tooth becomes infected. This condition is a complication of untreated cavities, which leads to bacteria in the pulp, causing severe inflammation and pain. These infections can also spread to the jaw bones or sinuses. Alongside cavity pain, abscess symptoms include:

As with tooth decay, poor oral hygiene, smoking, and dietary starches and sugars are risk factors for tooth abscesses.

Tooth Fracture

Cavities can also occur due to broken or cracked teeth. Tooth fractures can result from sports injuries, car accidents, falls, or biting down on a bone or other hard substance. The scope of the damage varies, and it can impact just the outside enamel or affect the pulp and root.

Pain and tooth sensitivity are the primary symptoms of a fracture, alongside other signs of cavities, such as sensitivity to air, temperature, or pressure. Fragments of teeth can also become lodged in the tissues of the mouth or gums, causing bleeding, facial swelling or puffiness, and hematoma (pooling of blood).

Dental Restoration Failure

Damaged dental restorations—such as fillings, dental crowns, or veneers—can also lead to cavity pain. Cavities form as food and bacteria build up beneath the restoration. This can occur due to decay in the surrounding tooth, cracks in the restoration or bonding material, bite problems, or trauma. If left untreated, this can lead to abscesses, infections, and tooth loss. 

Teeth Grinding

Grinding your teeth while you sleep (bruxism) is another common cause of cavity pain. Grinding puts more pressure on your teeth, causing them to chip or crack or the enamel to wear thin. This damage can cause cavity pain and tooth sensitivity. The strain on joints and muscles causes additional symptoms, including:

• Sore or tight jaw muscles
• Jaw muscle fatigue
• Headache
• Facial pain

Less Common Causes 

Some other health conditions can also cause tooth decay and cavities. These include:

• Gastroesophageal reflux disease (GERD): Causes heartburn and difficulties swallowing when stomach acids flow back up to the esophagus, sometimes reaching the mouth and damaging teeth
• Eating disorders: Sometimes causes self-induced vomiting after eating foods, which can trigger stomach acids to come into contact with your teeth and increase the risk of cavities

It’s important to have regular dental cleaning and checkups. Depending on your oral health, you should have an appointment once every 6-12 months. Since cavities worsen without treatment, any sign of a cavity also prompts a call to your dentist. These signs include:

• Tooth pain and discomfort
• Sensitivity to air, pressure, and hot or cold temperatures
• Visible black spots on the teeth

Some dental issues require prompt attention. Get immediate dental help if you experience any of the following:

• Severe toothache that disrupts daily living
• Broken, cracked, or lost tooth
• Swelling in your face or jaw
• Broken or missing dental crown, filling, or other restoration
• Deep cuts or injury to soft tissues in the mouth, such as the gums or tongue

When you see a dentist about tooth pain or cavities, they’ll ask about your symptoms and conduct two exams to offer an accurate diagnosis. These tests include:

• Dental examination: Detects cavities using specialized instruments to look closely at the teeth and prod at their surfaces to detect weakened areas
• Dental X-ray: Takes a closer look at the scope of the tooth decay, fracture, or other damage while screening for abscesses or other complications

There are several ways to treat cavity pain. The three most recommended options include dental treatments, medications, and home remedies.

Dental Treatments

If you have a cavity, fracture, or other dental concern, your dentist will offer one or more of the following treatments for symptom relief:

• Fillings: Removing decayed teeth by applying amalgam, composite resin, or glass ionomer to the tooth
• Crowns: Applying caps made of porcelain, gold, or porcelain fused to metal on the remaining part of damaged teeth after removing decayed portions
• Root canal: Taking out the center of the tooth and filling it with specialized material, which is usually necessary if the pulp is infected or there’s extensive nerve damage
• Tooth extraction: Pulling out a severely damaged tooth and potentially using a bridge or dental implant to replace the missing tooth
• Fluoride treatment: Using fluoride (a mineral that promotes tooth health) in the form of gel, foam, or varnish to treat minor cavities

Medications

Medications can treat bacterial infections, remove tooth decay, and manage pain and discomfort. Depending on the severity of your pain, these medications can be available over the counter at your local pharmacy or via a prescription from your dental care provider. These medicines may include:

• Analgesic medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like Motrin (ibuprofen) or Tylenol (acetaminophen) to help reduce pain and inflammation
• Antibiotics: Moxatag (amoxicillin), AzaSite (azithromycin), or Nuvessa (metronidazole) to heal bacterial infections
• Antimicrobial mouthwash: Peridex (chlorhexidine), which is a common mouthwash that targets bacteria in the mouth

Home Remedies

While you should seek dental care if you have cavity pain, specific home remedies may also alleviate symptoms as you wait for an appointment with your dentist. Consider these strategies for temporary symptom relief:

• Avoid hot or cold foods or drinks
• Limit triggering foods, such as acidic or sweet foods
• Rinse your mouth with alcohol-based mouthwash
• Apply a cold compress or ice pack to the affected areas 
• Gargle with salt water
• Brush twice a day
• Floss daily

When bacteria in the mouth cause cavities, it’s common to experience symptoms like pain, discomfort, and tooth sensitivity. Most cavity pain is from tooth decay, but fractures, abscesses, and teeth grinding can also lead to symptoms.

Get treatment if you’re experiencing cavity pain or notice changes to your teeth. If left untreated, your symptoms can worsen and increase the risk of complications like infections and tooth loss.