What Causes Tooth Decay and When Do You Need To Get It Out?

Tooth decay happens when harmful bacteria in your mouth break down sugars and starches into acids, which erode your enamel and form cavities. If left untreated, this can lead to pain, infection, and even tooth loss, making early detection and treatment vital.

If you’re already experiencing discomfort or suspect a cavity, it’s important to seek a qualified dentist who can assess whether the decay can be treated with a simple filling or if extraction is necessary. In some severe cases, such as deep decay in molars, a replacement may be needed — dental implants offer a natural-looking, permanent solution.

What Causes Tooth Decay?

Tooth decay is caused by the demineralisation of enamel due to acid attacks from bacteria living in plaque. But there’s more to it than just skipping brushing.

Plaque and Acid Production

Bacteria in your mouth feed on sugars from food and drinks, producing acids in the process. These acids cling to your teeth as plaque, wearing down enamel and creating cavities over time.

Poor Oral Hygiene Habits

Infrequent brushing or flossing allows plaque to harden into tartar, which accelerates decay. Not cleaning properly along the gumline or between teeth also increases your risk.

Sugary and Acidic Diet

Frequent snacking or sipping sugary beverages fuels bacterial growth. Even seemingly healthy choices like fruit juice can erode enamel if consumed too often without rinsing or brushing.

Dry Mouth and Medical Factors

Saliva helps neutralise acids and wash away food particles. Conditions like dry mouth (xerostomia), diabetes, or even certain medications reduce saliva flow, making your teeth more vulnerable to decay.

Genetic Predisposition

Some people naturally have thinner enamel or deeper grooves in their teeth, making them more prone to developing decay even with good oral care habits.

Symptoms of Tooth Decay

Tooth decay doesn’t always start with pain. Sometimes, the signs are subtle and by the time discomfort kicks in, the cavity may already be advanced. Recognising the early symptoms can help you seek treatment before the problem worsens. Noticing any of these symptoms below should be your cue to book a dental appointment. Tooth decay rarely gets better on its own. The longer you wait, the more damage it can do – both to your teeth and your wallet. 

Sensitivity to Hot, Cold, or Sweet Foods

If sipping iced water or biting into something sweet makes your teeth sting, it could be an early sign of enamel erosion or a developing cavity. This happens when decay exposes the dentin layer of the tooth, which contains nerve endings.

Visible Holes or Dark Spots

You might notice a small pit or stain on your tooth that wasn’t there before. These are often the first visual signs of decay. In front tooth decay, this can be particularly noticeable and should be addressed quickly to avoid cosmetic and structural issues.

Toothache or Persistent Pain

Dull, throbbing, or sharp pain in a specific area of your mouth – especially when chewing – often means the decay has reached the inner pulp of your tooth. At this stage, simple fillings may no longer be enough, and root canal treatment might be required.

Bad Breath and Foul Taste

Tooth decay creates a breeding ground for bacteria, which can result in persistent bad breath or a sour taste in your mouth, even with regular brushing.

Swelling or Gum Inflammation

Decay close to the gumline, such as in wisdom tooth decay, can irritate or infect surrounding tissue. This can cause swelling or pain in the gums and jaw.

Stages of Tooth Decay

Tooth decay doesn’t happen overnight. It develops gradually, moving through distinct stages – and each stage requires a different approach to treatment. The sooner it’s caught, the easier (and less expensive) it is to manage.

Enamel Caries

Tooth decay begins with the loss of minerals in the enamel, often showing up as faint white spots. As acids continue to erode the surface, small cavities can form, leading to sensitivity. At this stage, decay is still manageable—fluoride treatments, improved oral hygiene, or a simple filling from your dentist can restore the tooth’s health.

Dentin Caries

When decay breaks through the enamel into the dentin — the softer layer underneath — it spreads more quickly. The tooth becomes increasingly sensitive to hot, cold, or sweet foods. Without timely treatment, cavities can enlarge and compromise the tooth’s structure, making professional dental care essential.

Pulpitis

If bacteria penetrate deep enough to reach the pulp, where nerves and blood vessels reside, the pain intensifies. This infection often causes swelling and severe discomfort. Root canal therapy is typically required at this stage to save the tooth and stop the infection from worsening.

Periodontitis

Left untreated, the infection can spread beyond the pulp and form an abscess near the root. This pus-filled pocket can cause extreme pain and swelling, and in severe cases, the infection may reach the jawbone or bloodstream. Advanced intervention, sometimes including tooth extraction may be needed to protect your overall health.

How to Stop the Pain of Tooth Decay With Home Remedies

Tooth decay pain ranges from dull aches to sharp, shooting pain when eating or drinking. Whether it’s a mild discomfort or unbearable, the sooner you address it, the better the outcome.

Immediate Relief at Home

If you can’t get to a dentist right away, there are a few ways to manage the pain temporarily:

• Saltwater rinses help reduce inflammation and clean the affected area. Mix half a teaspoon of salt in warm water and swish it around for 30 seconds.

   

• Over-the-counter pain relievers like paracetamol or ibuprofen can help ease the discomfort.

   

• Cold compresses applied to the outside of your cheek may reduce swelling and numb the pain.

   

• Clove oil, a natural remedy with numbing properties, can be dabbed directly onto the tooth with a cotton swab. It’s not a cure, but it can help in a pinch.

   

Despite these measures, tooth decay pain will persist until the underlying cause is treated professionally.

Dentist Solutions for Lasting Relief

When you visit a dentist, you’ll be examined for the extent of the decay. Based on the diagnosis, your dentist might recommend:

• A filling for minor cavities

   

• A root canal for pulp infection

   

• A crown to restore a broken-down tooth

   

• Or a tooth extraction for teeth that are beyond repair

   

These procedures are designed not just to stop the pain, but also to restore full function and prevent further damage.

If you’re already feeling discomfort, don’t delay. Pain is a clear sign that the decay is progressing and needs professional intervention.

Tooth Decay Treatment Options

The type of treatment depends on how far the decay has progressed. Early stages are easier to manage, while advanced decay may require surgery or extraction.

Fluoride Treatments

For the earliest stage of decay – demineralisation – fluoride can help reverse the damage. Dentists often apply a concentrated fluoride varnish or gel to strengthen enamel and stop decay from progressing.

Dental Fillings

Once a cavity forms, it cannot be reversed, but it can be repaired. Your dentist will remove the decayed portion and fill the hole with a composite material that blends with your tooth colour. This stops further bacteria buildup and restores function.

If you’re experiencing front tooth decay, a tooth-coloured filling is particularly important for aesthetic reasons. At Fresh Dental Kepong, we offer natural-looking restorations that blend seamlessly with your smile.

Root Canal Therapy

When decay reaches the pulp, root canal therapy is often the only way to save the tooth. The dentist removes infected tissue, disinfects the root canals, and seals the tooth with a crown. It may sound intimidating, but it’s often no more uncomfortable than getting a filling.

Tooth Extraction

In extreme cases where the tooth is beyond saving, it will need to be removed. This is often necessary with wisdom tooth decay, where impacted or hard-to-reach molars become chronically infected.

If you’re considering replacement options after an extraction, dental implants in Kepong are a permanent solution that restores both function and appearance.

Frequently Asked Questions