White spots
Acid has started to pull minerals out of the enamel, leaving chalky patches. No hole yet, and this is the only stage that can reverse.
How to reverse it
# Tooth Decay
Tooth Decay (Cavities)
Tooth decay is damage caused when bacteria in plaque turn sugar into acid that dissolves the enamel, leaving a cavity. It starts as a chalky white spot that can still be reversed with fluoride, then becomes a brown or black hole that needs a filling. Left untreated, it reaches the nerve and needs a root canal or extraction.
What Are the Signs of Tooth Decay?
Early decay is easy to miss because it rarely hurts. These are the signs to look and feel for:
The earliest sign. A dull white patch means the enamel has started to lose minerals; at this stage it can still harden again.
As decay breaks through the enamel it turns brown or black and leaves a pit you may feel with your tongue or catch food in.
Once decay reaches the softer layer underneath, sugar, ice cream and hot tea set off a short, sharp pain in that tooth.
Pressure on a weakened, hollowed tooth hurts, and pieces of it can start to break away.
Food packing into one spot again and again often means a cavity between two teeth that you can't see.
Food and bacteria trapped in a cavity rot and give a bad taste or smell that brushing doesn't fix.
Decay between the teeth often shows nothing at all until it is deep. A check-up with an X-ray finds it while a small filling will still do.
Book a Free ConsultationWhat Are the Stages of Tooth Decay?
Decay moves inwards in stages. The earlier it is treated, the smaller and cheaper the fix:
Decay in the enamel
The surface breaks down into a small brown or black cavity. Usually painless, and fixed with a small filling.
Tooth-coloured fillingsDecay in the dentine
Decay reaches the softer layer underneath and spreads faster. The tooth turns sensitive to sweets and cold.
Fillings and crownsDecay reaches the nerve
The pulp becomes inflamed, causing throbbing pain, often at night. A filling alone is no longer enough.
Root canal treatmentAn abscess forms
Bacteria reach the root tip and form a pocket of pus, with swelling, a bad taste and sometimes a fever.
Tooth infection guideThe tooth breaks down
So much of the tooth is lost that it breaks or can’t be saved, and it has to be removed and replaced.
Tooth extractionWhat Causes Tooth Decay?
Decay needs three things: bacteria, sugar and time. These habits give it all three:
Sugar, often
It is how often, more than how much. Sugary chai through the day, biscuits, mithai and soft drinks keep teeth under acid attack for hours.
Plaque left on the teeth
The sticky film of bacteria turns sugar into acid. Missing the gum line and the gaps between teeth gives it a place to stay.
Snacking and sipping
Each snack or sweet drink starts a new 20 to 30 minutes of acid. Grazing all day never lets the enamel recover.
A dry mouth
Saliva neutralises acid and repairs early damage. Medicines, mouth breathing and long fasts that dry the mouth raise the risk.
Deep grooves and crowded teeth
Deep pits in back teeth and overlapping teeth trap food where a toothbrush can’t reach.
No fluoride or check-ups
Fluoride hardens enamel. Without fluoride toothpaste and regular check-ups, small cavities grow unnoticed.
Can a Cavity Heal on Its Own?
Only at the very start. Once enamel has broken into a hole it can't grow back, however well you brush:
Can still be reversed
- Chalky white spots with no hole
- Found early at a check-up or on an X-ray
- No pain or sensitivity yet
- Helped by fluoride, less sugar and good cleaning
Needs a dentist
- A brown or black hole you can see or feel
- Sensitivity to sweets, cold or hot
- Pain when you bite, or pain that throbs
- Food catching in the same place every time
Home remedies such as clove oil can ease the pain of a cavity for a while, but they don't remove the decay. Book a check-up.
How Can I Stop Tooth Decay From Getting Worse?
These habits stop new cavities and can reverse decay while it is still at the white spot stage, for adults and children alike:
- Brush twice a day for two minutes with a fluoride toothpaste, then spit it out without rinsing so the fluoride stays on your teeth.
- Floss or use interdental brushes once a day; most adult cavities start between the teeth.
- Keep sugar to mealtimes. Cut down on sugar in chai, and swap biscuits and mithai between meals for fruit, nuts or yoghurt.
- Drink water after sweet food or drinks, and chew sugar-free gum to bring up saliva.
- Don’t put children to bed with milk, juice or a sweet bottle, and brush their teeth for them until about age seven.
- Ask about fluoride varnish and fissure sealants for children’s back teeth.
- Have a check-up every six months so early decay is caught while it can still be reversed.
Already have pain or a hole? Prevention won't fix an existing cavity. Our guide to toothache explains what to do until you see a dentist.
What Is the Best Treatment for Tooth Decay?
The treatment depends on how deep the decay has gone. After an examination and an X-ray, these are the treatments we use at DentoCorrect:
Tooth-Coloured Fillings
The decay is removed and the tooth sealed with a composite filling matched to its shade. Most cavities are fixed this way in one visit.
Dental Crowns
When decay has destroyed a large part of a tooth, a crown covers and strengthens what is left so it doesn’t crack.
Root Canal Treatment
When decay reaches the nerve, the infected pulp is cleaned out and sealed, saving the tooth and ending the pain.
Extraction and Implant
A tooth too broken down to save is removed, and an implant replaces it so the teeth beside it don’t drift.
Why Choose DentoCorrect for Tooth Decay?
DentoCorrect is Pakistan's ISO-certified, multi-city dental clinic network with qualified dentists at every location. Here is what sets us apart:
Qualified, Registered Dentists
Experienced dentists at every DentoCorrect clinic
Decay Caught Early
Careful check-ups and X-rays find cavities while they are still small
ISO-Certified Standards
Strict safety and sterilisation protocols at every clinic
We Try to Save the Tooth
Fillings and root canals first; extraction only as a last resort
Transparent Treatment Plans
You'll know what's needed and what it costs before we begin
Conveniently Located Across Pakistan
Lahore (Johar Town, Gulberg & DHA), Islamabad, Rawalpindi, Karachi, Faisalabad, Peshawar, and Multan
# FAQ'S
Frequently Asked Questions
Only at the very first stage. Chalky white spots where the enamel has started to soften can harden again with fluoride toothpaste, less sugar and good cleaning. Once there is an actual hole, the tooth can't grow back, and the cavity needs a filling before it gets bigger.
No. There is no worm. The old belief comes from the dark, hollow look of a decayed tooth. Decay is caused by bacteria that turn sugar into acid and dissolve the tooth. Treating it means removing the decay and filling the tooth, not killing a worm.
Early decay looks like a chalky white or light brown patch. As it grows it turns brown or black and becomes a small hole or a dark line around an old filling. Decay between the teeth often can't be seen at all and only shows on an X-ray.
No. Dark spots in the grooves of back teeth can be stain from tea or food. But a black spot can also be decay that is spreading underneath, so it is worth having it checked, especially if it catches food or feels sensitive.
There's no safe waiting time. Small cavities often grow slowly over months without pain, then speed up once they reach the softer inner layer. By the time it hurts, the decay is usually near the nerve, so the treatment is bigger and costs more.
Usually not. The tooth is numbed with a local anaesthetic first, so you feel pressure and vibration but not pain. The tooth may be a little sensitive to cold for a few days afterwards.
Yes. Baby teeth hold space for the adult teeth and decay in them can cause pain, infection and early loss. Children's cavities can also spread quickly because their enamel is thinner, so have them checked rather than waiting for the teeth to fall out.
The same bacteria and habits affect all your teeth, and decay between two teeth often damages both. Treating a cavity early and cutting down how often you have sugar protects the teeth around it.
It depends on the size of the cavity and the material used. A small tooth-coloured filling costs much less than a large one, a crown or a root canal, which is why treating decay early saves money. At DentoCorrect the dentist checks the tooth and tells you the full cost before starting.
In Urdu tooth decay is usually described as danton ka kharab hona or keera lagna (دانتوں میں کیڑا لگنا). Dentists call it dental caries.