Symptoms of Dental Caries

The cruel trick of tooth decay is that it hurts only when it is nearly too late for a simple fix. Knowing the symptom ladder tells you how far things have gone.

The symptom ladder

• Stage 1 - nothing at all: early enamel decay is completely painless. A white or brown chalky spot on the tooth may be the only sign - and it is reversible here
• Stage 2 - sensitivity: a sharp twinge to cold water, sweets or hot tea that stops when the trigger stops. Decay has reached or neared the dentin
• Stage 3 - visible hole and food catching: a pit or dark hole you can feel with the tongue; food packs into it after meals
• Stage 4 - real pain: deeper, longer-lasting pain, worse at night, sometimes throbbing - the pulp (nerve) is inflamed
• Stage 5 - the danger zone: spontaneous severe pain, pain on biting, gum boil, facial swelling, fever - the infection has left the tooth. This needs a dentist urgently, not a painkiller and patience

In children, watch instead

• Complaints of tooth pain at night, avoiding chewing on one side, new refusal of cold or sweet foods
• Visible brown spots or holes on the front milk teeth
• A child who stops sleeping or eating well around tooth pain

The honest rule

Pain that disappears on its own is not good news - it can mean the nerve has died while the infection continues quietly. Any tooth symptom that lasts more than a day or two deserves a dental visit, and swelling or fever deserves one today.

One-line summary

Dental caries climbs a ladder from silent white spot, to sweet-cold sensitivity, to a visible hole, to night pain, to swelling and fever - and because pain arrives late, checkups and early spots matter more than painkillers.