Hole In A Tooth And How To Fix It?

a hole in a tooth
Patient with a hole in a tooth

A hole in a tooth generally develops from tooth decay. It is estimated that between the age of 20-60 years about 90% of people have one or cavities. This is the second most common disease globally and the most common cause of toothache among children, teenagers, and adults.

The bacteria present in the mouth demineralizes the highly mineralized outer layer of the tooth and penetrate the inner layers. When enough tooth structure is destroyed by bacteria the affected wall of the tooth breaks down and a hole in a tooth is formed. The whole process is known as tooth decay or dental caries.

What Causes a hole in A tooth?

Plaque and tartar buildup on teeth begin the process of tooth decay. Improper brushing and flossing, frequent snacking, and intake of refined foods lead to the deposition of food debris on the teeth. The plaque biofilm provides a nidus for bacteria to thrive.

The bacteria convert simple sugars into acid that demineralizes the outer layer of the tooth. If dental plaque is not removed within 48-72 hours, it hardens and converts into tartar. Tartar is not removed by brushing or flossing and requires mechanical removal by a dentist. 

Tooth decay takes several months to years to breach the outer tough enamel, destroy the inner layers of the tooth and cause pain. Frequent intake of sugar and acidic food lowers the pH of plaque and tartar and strips the mineral of the highly mineralized enamel 1

Saliva has enzymes and minerals that neutralize acid and gives lost mineral back to the enamel. It takes 20-30 minutes for the saliva to remineralize the enamel. Frequent snacking on refined foods increases the episodes of enamel demineralization giving bacteria a chance to breach the enamel.

The bacteria while making their way to the inner pulp produces enzymes and destroy the dentin and elicit occasional episodes of pain or sensitivity while eating or drinking.

Why do cavities hurt?

The invasion of bacteria into the pulp provokes lingering throbbing pain. Pulp has a rich blood and nerve supply and the entry of bacteria, or its products elicit an immune response. Hard dentin surrounds pulp from all sides with a small opening at the tip of the root from where blood vessels and nerves enter the tooth. The release of inflammatory mediators in response to bacteria or its products causes the fluid to come out of vessels. This fluid could not escape or expand the pulp tissue and stimulate the nerve ending in the immediate vicinity causing severe throbbing and lingering pain. Medication or opening the tooth by a dentist relieves pain

In some cases, the fluid compresses the vessels and nerves making the tooth dead. In such cases, one might experience no pain at all after some severe episodes of pain.

How to know if hole in a tooth is tooth decay?

If you have a black spot or a hole in a tooth you should go and see a dentist. He will check with an explorer and take a bitewing x-ray to see the spread of decay. Additionally, you may experience moderate to severe episodes of pain while eating and drinking, or pain may start spontaneously.

Based on the stage of inflammation of the inner pulp, pain may last for a few seconds to hours. You may need a painkiller to relieve it. It gets worsen on lying down. One or more of these signs and symptoms could be related to a cavity.

What do dentist do about a hole on tooth?

A hole in a tooth ranges from a small cavity to a massively destroyed tooth. Small to moderate hole in a tooth requires restoration with a white or a silver filling, however, for larger ones where the infection spreads to the inner pulp the dentist opts for a tooth canal treatment. For detailed treatment options look for cavities in between teeth.

How to avoid tooth decay?

Following measures can help to prevent rotting teeth:

  • Avoid refined foods and sugary foods and switch to a healthy diet rich in all the essential nutrients i.e., vitamins and minerals. Vitamin D and calcium are very important for healthy teeth and bones. Incorporate green leafy vegetables and other raw colored vegetables in your diet because of their property to scrub bacteria and food debris off the teeth.
  • Limiting the frequency of snacking.
  • Proper brushing with fluoridated toothpaste twice daily and flossing teeth once a day.
  • Fluoride treatments are helpful in people who don’t get enough fluoride from water and other sources and are at high risk of getting caries.
  • Pits and fissure sealants in newly erupted back teeth are also useful against caries. The tendency for cavities increases in patients with low salivary flow secondary to any disease or head and neck radiotherapy and pits and fissure sealants help prevent decay.
  • Regular dental visits can intercept early cavities.
  • Schedule an appointment with your dentist for professional scaling and root planning of teeth every 6-12. However, don’t forget to clean the backside of the lower front teeth as salivary ducts open under the tongue and let the calcium and phosphate from saliva mineralize plaque.


Cavities are a frequent occurrence in people of all ages and the most common cause of toothache. The infection affects different layers of teeth and causes pain and swelling. Sweet and refined foods and bad oral hygiene influence the formation of cavities. Therefore, Proper diagnosis and early treatments restore the teeth and save them from further decay.


  1. Touger-Decker, Riva & Loveren, Cor. (2003). Sugars and dental caries. The American journal of clinical nutrition. 78. 881S-892S.

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