What to Do if You Have a Hole in Your Tooth

Evidence Based
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What Causes Holes in Teeth?

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

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 breakdown the sugars in food to create an acid, which essentially creates a hole in the tooth. A cavity is a small hole in the tooth.


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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 creates a film that is soft and sticky that we refer to as plaque. 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: children, teens, and adults. 

class ii cavity

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 either keeps you up at night or that 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

What to Do if You Have a Hole in Your Tooth

If you are suspicious that you have a hole in your tooth, call your dentist immediately. Dentists will generally use an X-ray to determine the extent of tooth decay. Treatment options for tooth decay include:

  • A filling or a 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 an 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.

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. The good news is that there are some easy things that can be done daily to prevent tooth decay, 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.
  • Fluoride treatments. 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 the 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.
  • Whenever possible, drink water with fluoride in it as a way to strengthen your tooth enamel.
  • If you are experiencing a persistent dry mouth, visit your dentist and tell them about it.
  • Cleaning between your teeth daily with floss 

Ask your dentist about using supplemental fluoride, which strengthens your teeth. Also ask about using dental sealants, which are a plastic protective coating that can be put on the chewing surfaces of your back teeth. This is the area where decay typically starts. Sealants can help protect from tooth decay.


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Tooth decay. (n.d.). NHS, https://www.nhs.uk/conditions/tooth-decay/

Cavities. (n.d.). Mouth Healthy, https://www.mouthhealthy.org/en/az-topics/c/cavities

Dental Caries in Adults (Age 20 to 64). (n.d.). NIH, https://www.nidcr.nih.gov/research/data-statistics/dental-caries/adults

Updated on: October 20, 2020
Medically Reviewed
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Lara Coseo