Updated: Oct 14
Cavities will feel different depending on the severity and extent of the decay. In other words the stage of tooth decay will affect how a particular cavity will feel and consequently the symptoms that they manifest.
The stage that the decay is in can basically be classified based on where it is located in the tooth. Is it in the enamel or is it in the dentin? Perhaps it has already reached the pulp.
Below is a diagram of the different layers of a human tooth for visualization.
All cavities start at the outermost layer which is the enamel. Then it moves towards the dentin and ultimately into the nerve. As the decay works deeper into each layer of the tooth, it starts to feel different because it encounters more and more nerve endings.
The sensations from the nerve endings in each layer may provide warning signs of a cavity. However if you don't feel anything it does not preclude you from having decay in your teeth. Teeth are interesting in that sometimes they never hurt you until the very last moment when it is too late.
Well as long as you understand all of that, we can proceed in describing what cavities feel like at each stage of tooth decay:
What cavities in the enamel feel like
Decay that is located solely in the enamel of the tooth is one of the first stages of a cavity. That is basically where the cavity starts and forms since it is the outermost layer of your tooth.
Enamel decay is asymptomatic the vast majority of the time. In other words, you typically don't feel anything at all if the cavity is located just in the enamel layer.
This type of cavity will not elicit any sensation such as pain nor sensitivity because it is situated in the enamel only. The reason is because the enamel is not alive so it does not have any nerve endings. Since there are no nerves there, it makes it impossible for your tooth to sense anything at all.
You may think that is a terrible thing to have but the reason why you don't cringe every time you drink something cold or hot is because the nerveless enamel layer can't feel it! It makes for a great protective covering for the sensitive dentin layer underneath it. It's a double edged sword since it prevents the tooth from feeling anything but at the same time it prevents you from knowing that you have a cavity.
Therefore if you have a small cavity that is starting to form in the enamel, you most likely won't be able to feel it. Due to that reason alone, it makes it very important for you to get routine dental check ups so that you can catch these cavities. Just because you don't feel anything it does not preclude you from having cavities.
What cavities in the dentin feel like
Untreated enamel cavities will progress into the next layer of the tooth, the dentin which actually contains nerve endings. What this means is that this is the earliest stage of decay that you can potentially feel a cavity.
What it feels like:
May feel sensitivity while eating sweets.
Potentially cold sensitive.
We would like to emphasize that you may feel sensitivity to sweet or cold if you have a cavity that has reached the dentin. Not everyone will feel it despite there being nerve endings present in that layer. It really is quite the strange phenomenon because only a small subset of individuals can feel this type of cavity. It is more likely that you won't feel dentin decay.
What cavities in the pulp feel like
The most advanced stage of tooth decay is when the cavity has reached the pulp of the tooth, where the bulk of the nerves are located. Since it is the layer where the tooth nerve is located you can bet yourself that you will feel something but it's not something that is pleasant.
What a cavity that has reached the pulp feels like:
Extreme nerve pain that is unbearable at times
Throbbing toothache that can come and go
Pain that is unprovoked, can wake you up in your sleep
Sensitive to sweet, cold, and hot
Pain when biting down
As you can see from the list of signs and symptoms above, decay that is in the pulp elicits significantly more sensations. This is in stark contrast to cavities that are in the enamel or dentin.
What is unfortunate about this is that once the decay has infected the nerve, treatment for it becomes more complicated and expensive. A tooth with this condition will require a root canal and a crown. You can compare this to a small cavity, which only needs a simple cavity filling and that costs significantly less.
Basically your body does not give you much warning signs for when a small cavity is growing. It only notifies you once it is almost too late when the cavity has reached the nerve. Although by that time, you'll be forced to spend a lot more money on your dental care.
You may be surprised but cavities that have reached the nerve can also have no sensations as well. This actually happens if you manage to bear through the nerve pain of when the decay has reached the pulp.
When it first gets to the nerve it will cause excruciating pain but after a while, the nerve will die. Once the nerve has completely died, there is a chance you'll stop feeling pain.
Some patients think that whatever was bothering them must have self-resolved since the pain has gone away but don't be fooled. Just because it has stopped bothering you, it does not mean the cavity has miraculously disappeared. The decay is still present and will be traveling down the root of the tooth. Once it does it will form an abscess there.
Once the abscess forms, it can travel through the bone and form a little pimple on the gums called a gum boil.
If you notice a gum boil, you definitely need to go see a dentist because that is a full blown tooth abscess. You cannot leave that untreated in your mouth!
Takeaway - How to tell if you have a cavity or not
Unfortunately it is quite difficult to tell if you have a cavity or not when it is small and still forming. There are literally no warning signs since the enamel layer has no nerve endings. Even when the cavity has progressed to the next layer, the dentin most people still wouldn't feel anything. Only a small subset of people will be able to feel some sweet or cold sensitivity when the decay is in this layer.
It is only when the cavity has gotten big enough to reach the nerve of the tooth that most people can feel it. Usually by this time it is too late in that conservative treatment like a cavity filling will be insufficient. You'll most likely need a root canal and a crown which is far more complex and expensive than the filling.
We would prefer for you to not have to go through complicated nor expensive treatment which is why we do recommend that you see a dentist regularly. If you can catch them while they're small you can save yourself a lot of time and money.
Nonetheless, just to summarize we would not leave it up to whether or not you feel anything as a means of telling if you have a cavity or not. It is much more accurate to let your dentist do a dental check up and take x-rays to check for cavities.
Aside from feeling if you have a cavity or not, you should also couple that with how they may look. Cavities will typically look different from your regular tooth structure. It'll be brown to black in color. The texture may also be soft or cavitated if it is very advanced.
Related content: We have an entire article dedicated to what a cavity looks like in case you were curious in exploring!
Nonetheless, if you're in need of a dental filling in long island city, our office have got you covered! We accept just about every PPO dental insurance.