What to Do if You Have a Hole in Your Tooth

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Medically Reviewed
by Dr. Lara Coseo
Alyssa Hill
Written by
Alyssa Hill
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Evidence Based
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3 sources cited
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What Causes Holes in Teeth?

There are a few common causes for holes in teeth, including teeth grinding (bruxism) and cavities. However, the main cause of holes in teeth is tooth decay.

In the early stages, a cavity is a small hole in the tooth. This cavity will get larger without treatment.

According to the National Institute of Dental and Craniofacial Research, 92% of adults 20 to 64 have had dental caries in their permanent teeth.

The human mouth is full of bacteria that create a film over our teeth known as dental plaque. When we consume food and beverages that are high in sugar, the bacteria in plaque break down the sugars in food to create an acid, which essentially creates a hole in the tooth.


Cavities start out as small holes in teeth. Excessive teeth grinding can also create holes.

What is Tooth Decay?

Tooth decay is the breakdown of tooth structure caused by acids made from bacteria.

Bacteria and food debris left behind from poor brushing create a film that is soft and sticky. It is called plaque.

class ii cavity

When plaque builds up, problems arise, including holes in the teeth and even gum disease. Tooth decay can be a problem for people of all ages, including children, teens, and adults. 


Tooth decay is caused by plaque buildup. If left untreated, gum disease and other oral health issues can develop.

Symptoms of Tooth Decay

You may not know if you have holes in your teeth because tooth decay doesn’t always cause pain.

Here are the most common symptoms associated with dental caries, or holes in the teeth:

  • Toothache — any pain that keeps you up at night or is sharp from time-to-time (without other obvious causes) can be a sign of tooth decay
  • Tooth sensitivity — feelings of tenderness or pain while eating or drinking things that are hot, cold, or sweet
  • Spots on the teeth that are black, brown, or yellow
  • Chipped or fractured teeth
  • Food getting stuck between your teeth
  • Bad breath
  • An unpleasant taste in the mouth


The primary indicators of tooth decay are persistent toothaches, sensitivity to hot/cold, and dark spots on teeth.

What to Do if You Have a Hole in Your Tooth

If you suspect that you have a hole in your tooth, call your dentist immediately. General dentists will generally use an x-ray to determine the extent of tooth decay.

Treatment options for tooth decay include:

  • A filling or crown — this is the process of removing dental decay and then either filling the tooth or covering the tooth with a crown.
  • Root canal — when tooth decay spreads to the middle of the tooth where the blood and nerves are, a root canal may be the only option to remove the decay and save your tooth from extraction.
  • Tooth removal — when a tooth is so badly decayed that it can’t be restored, your dentist might recommend removing the tooth and replacing it with a partial denture, implant, or bridge.


Treatment for tooth holes include fillings, a root canal, or complete tooth removal (depending on the severity of decay).

How to Prevent Tooth Decay & Holes in Teeth

Some people may think that only kids get tooth decay. According to the American Dental Association (ADA), children are at a higher risk of tooth decay than adults, but we are all at risk of tooth decay for our entire lives.

There are some easy things that can be done daily to prevent cavities and plaque buildup, including: 

  • Getting regular dental check-ups
  • Snacking on foods that aren’t high in sugar
  • Reducing how many sugary drinks you consume
  • Practicing good dental hygiene and brushing your teeth twice a day with fluoride toothpaste
  • Whenever possible, drink water with fluoride in it as a way to strengthen your tooth enamel
  • If you are experiencing persistent dry mouth, visit your dentist and tell them about it
  • Cleaning between your teeth daily with floss 
  • Rinse with mouthwash daily

Fluoride is a mineral that can help stop tooth decay from progressing. Fluoride can even reverse or stop early tooth decay. Fluoride helps protect teeth by strengthening the tooth enamel and helping to make teeth more resistant to acids from plaque that cause tooth decay.

If your dentist thinks you need more fluoride, he/she may apply a fluoride gel or varnish to your teeth, prescribe fluoride tablets, or recommend a fluoride mouth rinse.

Ask your dentist about using supplemental fluoride, which strengthens your teeth.

You can also ask about dental sealants, which are protective coatings that can be put on the chewing surfaces of your back teeth. This is the area where decay typically starts. Sealants can help protect your teeth from decay. These coatings are more commonly placed on primary (baby) teeth.


Optimal oral care is essential for preventing cavities/tooth holes. Fluoride supplements and sealants may also help. If you are concerned, ask your dentist about preventive care options.

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