What Does A Cavity Look Like?

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What does a cavity look like at each stage of its development? And, if you are able to identify a cavity in its early stages, is there anything you can do to halt and even undo the damage?

In this article, our focus is on tooth decay. By the time you have read all the way through to the end, you will have learned everything you need to know about cavities. Armed with this knowledge, you will be much better equipped to spot and prevent cavities from developing in the first place. You will also know what to do if you discover a more progressed dental cavity.

Without further ado, let us get right to it.

What a cavity looks like at each stage of tooth decay

Tooth decay is a gradual process. Cavities start with the gradual demineralisation of the teeth’s enamel and, if left untreated, culminate in full-blown cavities and abscesses that require fillings, root canals or even full extractions. Leaving cavities untreated also puts you at high risk not only of experiencing severe pain but also of developing some very serious health problems, ranging from gum disease to life-threatening infection. In other words, skipping your bi-yearly dental exams or daily toothbrushing are never worth it.

Cavities look different depending on how far progressed they are. If you’re lucky, you may be able to spot a dental cavity very early on and stop it from getting worse. The sooner you spot a cavity the better, because once the soft dentil layer underneath the outer enamel layer has become infected, the decay spreads very quickly through the inside of the tooth.

In this section of the article, we are going to talk about how a cavity looks and how the visual clues change depending on which stage of tooth decay you have reached.

White spots (Demineralization)

So, what does a cavity look like in the very beginning?

The first stage of a developing cavity is demineralisation. Demineralisation refers to the gradual erosion of the tooth’s outer layer of enamel.

Enamel is an incredibly hard-wearing material, and is in fact stronger than any other material found in the body, including the bones. Even so, enamel may become weakened by the acids produced by plaque. We all develop plaque in our mouths throughout the day – this is inevitable. The reality of plaque buildup and its harmful effects on your teeth is also why it is so important to remain dedicated to your daily oral health routine.

Even if you are very diligent about tooth brushing, flossing and using mouthwash, plaque may still erode some of your enamel over time. The first sign of developing tooth decay is tiny white spots appearing on the outside of the tooth structure. At this point, there is no pain associated with the impending cavity or tooth decay, which means you can easily overlook it. 

If you spot tiny white spots on any of your teeth, this is a certain indication that cavity development is coming down the pipeline. Take action right away; get extra dedicated to your oral hygiene habits, use fluoride toothpaste and mouthwash, and ask your dentist or dental hygienist about fluoride treatments. 

Attacking the tooth decay as soon as the early signs are showing may prevent cavities from developing. If the decay hasn’t spread to the dentin layer of your teeth, you may even succeed in remineralising and strengthening your enamel. In other words, it is possible to heal an early stage cavity, whereas only dental professionals are able to do anything about cavities that are further progressed.

Dark spots (Tooth enamel decay, dentin decay and pulp damage)

If the cavity development is not identified and treated in its earliest stage of development, the next thing that is going to happen is that the little white spots on the surface of the teeth turn discolored brown. They will gradually become darker and darker as the enamel is eroded and begins to decay.

It is very difficult to visually distinguish the second, third and fourth stage of tooth decay from each other. On the surface and to the naked eye, they all look the same. However, what is happening underneath the surface of the tooth’s enamel is vastly important.

The second stage of tooth decay is enamel decay, which is where the enamel has become so weakened by the acids from food particles and plaque buildup that it begins to decay.

The third stage of dental decay is dentin decay. On the surface, dentin decay only looks like a tiny hole in the tooth’s surface, but this is where things start to get much more serious. Dentin is the soft layer underneath the enamel, and as soon as the decay reaches it, it will spread very rapidly to the rest of the tooth, including the pulp, the blood vessels and the roots. 

At this point, you will inevitably experience tooth sensitivity, and you may experience hot and cold pain while chewing or drinking. 

Once the decay has reached the inside of your tooth, it is already too late to reverse the damage naturally. Only your dentist will be able to fix the problem with either a filling or a root canal.

Discolouration (Abscess formation and rot)

If left untreated, the final stage of tooth decay puts you at very high risk of experiencing extreme pain and sustaining permanent damage. In cases where the infection spreads to the surrounding tissues and facial bones, including the jaw, you may even be at risk of dying from the infection.

Untreated tooth decay tends to culminate in an abscess forming at the bottom of the tooth, and the entire tooth is going to rot from the inside out. This is also when infection may spread from the teeth roots to the surrounding tissues and bones.

Visually, the final stage of tooth decay is going to look like tooth discoloration, with the tooth changing colour from white to grey to eventually black. At this point, you are likely to experience agonising pain as well as other symptoms including bad breath and having a strange taste in your mouth. And make no mistake that it is the taste of rot.

It is rare for patients to wait to seek treatment until their tooth decay has reached the fifth and final stage, but if it happens, the tooth infection can be life-threatening by the time the patient is seen by a dentist, who in most cases will have no choice but to remove the entire tooth. The missing tooth, however, can later be replaced with an implant.

What causes cavities

You probably already have a good idea of what causes cavities. Still, let us go through the top reasons why people develop cavities, from the most to the least common reason.

Poor oral hygiene

Poor oral hygiene is often to blame when people develop tooth decay. 

There is a very simple explanation for this: Without the acids that are secreted by the bacteria in plaque, there would be nothing to erode the tooth enamel and usher along the tooth decay. 

Whenever you eat, food particles get stuck between your teeth and along your gum line, and plaque soon develops as a result. Food particles can contain acids in themselves, which only exacerbates the situation.

Of course, not eating is not an option, so the best thing you can do is to stick to your daily oral hygiene routine, which should involve tooth brushing and flossing between the teeth for at least two minutes twice a day. Use fluoridated toothpaste and mouthwash to really get rid of the plaque that builds up during the day. You should also make sure that you brush the gum line and not only the teeth, as plaque and food particles tend to get stuck in the gum pockets.

Most people brush their teeth first thing in the morning and again as the last thing before they go to bed. Some manage to squeeze in a third tooth brushing session midday, typically after eating lunch.

Diet and lifestyle habits

The foods and drinks you consume can have a tremendous influence on how prone you are to developing cavities.

The worst foods to eat are sugary and acidic foods, particularly candy. Likewise, liquids that are very acidic or sugary also erode the enamel. Habits such as smoking and drinking alcohol are also detrimental.

Wearing braces or aligners

Wearing traditional braces or clear aligners is great for straightening teeth, but it is not so great for keeping them healthy and cavity free. This is particularly true for wearing braces, which are permanently attached to your teeth for the duration of your teeth straightening treatment.

If you are getting your teeth straightened with clear aligners, you at least have the option of removing them in order to eat, smoke or brush your teeth. Still, wearing aligner trays means that plaque has an easier time building up around or under the aligners, which puts you at higher risk of developing tooth decay. 

Traditional braces are even worse. It doesn’t matter whether they are ceramic or metal, the fact that they are stuck to your teeth for months and often years at a time means that you need to be particularly meticulous about staying on top of your toothbrushing and flossing if you want to steer well clear of developing caries.

How to prevent cavities

It is not always possible to stop cavities from developing, as some of the underlying causes are inevitable, such as for example having food particles in your mouth. 

Having said that, there is still plenty we can do to remain in charge of our own oral health and prevent cavities from developing. In this section of the article, we are going to talk about the most effective things you can do to keep tooth decay at bay.

Practice good oral hygiene

Good oral hygiene is the master key to great oral health.

The basics of oral hygiene consist of brushing and flossing between your teeth at least twice a day – and for a minimum of two minutes every time. One of the things that can sometimes erode enamel is overly forceful toothbrushing, so consider switching to a soft-bristled brush, and make sure that you are brushing in small circular motions rather than back and forth.

Always use fluoride toothpaste rather than one of the fluoride free variety. You may see activated charcoal or herbal toothpastes trending on social media, but that doesn’t mean they are effective at preventing tooth decay.

Regular dental exams

Attending dental exams twice a year is one of the best ways of ensuring that you will not develop dental decay that gets out of control.

Even now that you know what a cavity looks like at each stage of its development, one might still slip under your radar. After all, it can be difficult to check the backs of your teeth for any of the tell-tale signs of cavity development. Buying yourself a small dental mirror can help, but checking for cavities yourself is never a replacement for going to the dentist twice a year. 

Dentists are, per definition, trained to find and identify cavities, even in their earliest stage. In many cases, your bi-yearly visit to the dentist’s office can save you the agony of experiencing severe tooth decay later on.

Watch your diet and quit smoking

Try to minimise the amount of acidic and sugary foods you consume on a daily basis. Candy is worst, as it is almost pure sugar, but baked goods, fruit and cereals are also problematic.

As well as your diet, you should also be mindful of the liquids you consume. Try to eliminate or restrict fruit juice, energy drinks and other sugary beverages. Whenever possible, rinse your mouth after drinking anything other than water.

If you are a smoker, you are probably already aware that there are many health benefits to quitting. What you may not have been aware of is that smoking amplifies the formation of bacteria, plaque and tartar in your mouth.

Fluoride, fluoride, fluoride

Fluoride is absolutely necessary if you want to keep your teeth healthy and cavity free. We recommend always using fluoridated toothpaste, as well as a fluoride mouthwash and receiving regular professional fluoride treatments from your dentist or dental hygienist.

Cavity FAQ

How do you know a cavity?

If you are experiencing tooth sensitivity or pain, it might be a sign that you have a cavity. Visual markers to look for are either small white or brown dots on the enamel of your teeth, tiny holes in the enamel, or complete tooth discoloration. The latter is often accompanied by intense pain.

Regardless of which stage your cavity is at in its development, you should contact your dentist and set up an appointment as soon as possible. 

What does start of cavity look like?

The initial stage of cavity development is demineralisation of the tooth’s enamel. Visually this looks like tiny white spots forming on the surface of the tooth.

If left untreated, these tiny white spots will soon turn a darker and darker brown. If this happens, it is a sign that the enamel is decaying and that the decay is soon going to reach the soft dentin layer underneath the enamel. Once this happens, the infection is going to spread fast.

Can you physically see a cavity?

Yes, you can physically see a cavity, even in at earliest stage of development.

A cavity is going to look different depending on how progressed it is. Initially, cavities appear as tiny white spots on the teeth’s enamel. Of course, tiny white dots on your teeth can be difficult to see, so it is possible that you may overlook them until they turn brown. When the spots turn brown, it means that the enamel has started to decay.

Can cavity go away by itself?

This rarely happens, and it can only happen if the cavity has not progressed past its initial stage of development. 

When a tooth decays, the first thing that happens is that the tooth enamel becomes eroded, which leaves the tooth vulnerable to decay. If you see tiny white spots on your teeth, it is a sign that you are experiencing the first stage of tooth decay. If you go all-in on toothbrushing, flossing and fluoride rinse and treatments at this point, you may be able to make the cavity go away before it really develops.

However, if you do nothing, the cavity is likely to progress from the initial stage to the second, third, fourth and even fifth and final stage. In other words, if you spot a developing cavity anywhere in your mouth, do not assume that it can go away by itself. Contact your dentist and follow their advice or suggested treatment.


Knowing what a cavity looks like as it develops is an important piece of knowledge to possess. When you know what to look for, you are much more likely to be able to spot a cavity before it becomes serious.

In some cases, if the tooth decay is only just beginning to set in, you may be able to reverse the damage. But for the most part, knowing what a cavity looks and feels like simply means that you will be able to seek help from your dentist sooner rather than later, once the decay has spiralled further.

As is always the case when it comes to dental issues, delaying treatment is never ever the right answer. So as soon as you see the tell-tale white or brown spots on your teeth, set up an appointment with your dentist right away.

Dr Febin Mary George - Editor

With more than 10 years as a dental surgeon, Dr Febin Mary George is passionate about educating consumers around the world to help look after their teeth.

She completed her Bachelor of Surgery at the Century Institute of Dental Science and Research Centre in 2010.

Alongside editing the International Journal of Dental Clinics she has also written for major publications including Thrive Global.