What Does a Cavity Look Like?

Knowing that you have a cavity can be surprising. You may wonder if there are ways you could have known sooner. The answer is yes. Sometimes there are subtle changes that indicate a cavity is forming. 

Let’s learn about what a cavity looks like and what you can do to protect your teeth.

What is a cavity?

A cavity is a hole that forms on your tooth. It’s also known as dental caries or tooth decay. 

It’s formed from acid that’s created by the combination of bacteria and leftover food particles on and between your teeth. This is called plaque and is the core cause of tooth decay.

What are the stages of a cavity?

Tooth decay tends to appear in different “stages.” Some of these cavity stages are visible while others are not. Learning and understanding these stages before seeing a dentist about your cavity is crucial to staying on top of your oral health. 

Stage 1: Demineralization or ‘white spots’

The earliest stage of decay comes in the form of white spots on your tooth. This is a sign that the enamel (the outside layer of your tooth) is weakening. Bad bacteria and acid that are found in plaque strip away vital nutrients from your teeth.

But, it’s important to know that you can reverse a cavity when it’s detected at this early stage.

Adding the correct nutrients, such as fluoride, back to your teeth and increasing your daily brushing and flossing will help with the reversal process. For safe and effective results, talk with your dentist about the products that will be best for you to use.

Stage 2: Enamel decay

This is the initial formation of an actual cavity. In this stage, the tooth structure is continuously being broken down, and the cavity is starting to move through the enamel layer.

You may or may not have increased tooth sensitivity in this stage since the enamel layer doesn’t have any nerve endings or blood supply. If you do get tooth pain, it may be the first sign of decay since some cavities are out of your direct line of sight. 

Depending on the location of the cavity and thickness of your enamel, your dentist may decide to watch a cavity of this size before treating it. You should always be proactive and get a dental exam to ensure the best results.

Stage 3: Invasion into the dentinal layer

This is the “invasive” stage where your cavity has progressed through the first layer of your tooth and invaded the dentin layer. This layer is softer and less resilient than the outside enamel layer.

Cavities that enter into the dentin tend to progress much faster and require professional treatment. Treatment may include fillings, inlays, or crowns. If a cavity in this stage isn’t treated in a timely manner, it may require additional treatment.

Stage 4: Decayed pulp and tooth pain

If your cavity isn’t treated, it may penetrate the dental pulp layer. The inner pulp layer is the heart of your tooth. It includes the nerve bundles and blood supply that keep your tooth alive. For this reason, you may have severe tooth pain if a cavity enters this layer. 

Your dentist will most likely suggest a root canal to remove and replace the damaged nerves. You will then need a crown, or “cap,” placed on top of the tooth to seal it from further bacterial invasion.

Stage 5: Abscess and distress

The final stage of a cavity occurs after the cavity has reached the dental pulp. The bacteria present can cause a tooth infection to form in your jawbone.

A tooth infection at this stage will cause severe throbbing pain as your body tries to fight off the infection. Antibiotics can help reduce this sensitivity but won’t completely heal the tooth. Depending on how severe the tooth damage is, your dentist may recommend a tooth extraction instead.  

What do cavities look like?

In cases where your cavity is visible, it’s important to keep in mind the stages of cavity formation. Your cavity may have these characteristics:

• Soft white spots

• Varying shades of brown (depending on the maturity of the cavity)

• Darker black color (may indicate an inactive cavity or one that’s progressing)

• Matte tone

• Rough texture

You may not always be able to see a cavity. It may be located in between your teeth where they touch. In these cases, a dental health professional may use an X-ray to diagnose you with a cavity.

How can you tell if you have a cavity?

Sometimes the visible symptoms of a cavity, like changes in your tooth color, can signal a cavity. But, seeking the help of a dentist to diagnose your cavity will be the most accurate way to know. Your dentist will examine your teeth carefully and use their instruments to feel if a cavity is active. The dentist will also take X-rays of your teeth to catch cavities that aren’t visible to the naked eye.

When should you see a dentist about a cavity?

If you have a cavity, it’s best to see a dentist as early as possible. If you don’t, the cavity can progress. Treating your cavity at an early stage will help reduce tooth pain and save as much of your natural tooth structure as possible. It can also save you money on costly treatments for an advanced cavity.

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Written by:

Zack Youngblood, DMD

Zack Youngblood, DMD, is a dentist who strives to change the general look of dentistry. Before stepping foot in the clinical field, he authored multiple works that helped dental students and dentists find their unique path in dentistry.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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