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Tooth decay is one of the most commonly diagnosed dental issues in the UK, but many people still think they only need a restoration when their teeth hurt. Patients often keep ignoring a dental visit until it does not hurt. However, cavities develop silently, and by the time it hurts, the degeneration is deeper, more complicated, and thus, generally requires more extensive and expensive treatment.
Understanding the reasons you may need a dental filling, even when you have no pain, can protect your oral health, help avoid problems in the future, and preserve your natural teeth from further invasive treatment. This blog will outline how cavities develop, the importance of fillings in the early stages, and what can occur when tooth decay is left untreated.
Pain typically ensues when tooth decay reaches the inner layer of the tooth where the nerve is present. Early cavities are typically restricted to the enamel or outer dentine, which have no pain receptors. Therefore, the cavity can continue to progress silently.
Here’s what occurs:
Before a cavity develops, the surface of the enamel begins to erode from acidic foods or bacteria. You may observe white spots, which indicate that the enamel has lost minerals (demineralisation) – an early sign of decay. At this stage, you may not experience any pain.
At this stage, the enamel the enamel has broken down, forming a cavity and the bacteria can now reach into the softer dentine. Typically, most individuals do not feel anything at this intervening stage.
In this stage, Dentine decay progresses more quickly because dentine is softer and contains microscopic tubules. You may feel some sensitivity to hot or cold; however, most individuals still do not experience any pain.
After the decay reaches down the pulp (the nerve), this is when pain typically appears. At this stage, the process may no longer be simply treated with filling and require a root canal procedure.
Therefore, relying solely on pain as a warning is a risk.
A dentist will use small mirrors, digital x-rays and special instruments to detect early cavities long before you become symptomatic. Routine visits are the most common mechanism of tooth decay management; the need to intervene early and economically.
Small cracks can allow bacteria and plaque to accumulate. These cracks are often undetectable to the untrained eye and are painless until the decay becomes more extensive.
Existing fillings may crack, shrink, or become worn over time, leaving microscopic spaces for bacteria to enter. However, during an examination, the dentist can identify these earlier than you would realise.
With gum recession, the roots typically become exposed. The root dentine will decay significantly faster than the enamel. Cavities that form at or near the gumline frequently do not hurt, however, these do need to be treated with fillings promptly.
Cavities between teeth are extremely common but are generally out of sight without x-rays. The cavities will develop silently, often undetected until the time of routine assessments or hygiene visits.
Many patients question why they need to treat a tooth if there is no pain, but it is much more beneficial to treat earlier instead of waiting.
A small filling will preserve more of the natural tooth structure. If decay spreads it will need to remove a larger portion of the tooth.
Catching decay early can prevent needing root canal therapy later on.
Early fillings take less time, are easier and cheaper.
Weak tooth structure is more likely to fracture, and a filling can restore lost structure and reduce this risk.
Neglecting the urgency of any early decay could result in an insufferable scenario involving pain and swelling or infection severity. So eventually, a trip to an emergency dentist in London becomes a necessity.
Early cavities are virtually painless, which is why practitioners depend on sophisticated diagnostic tools:
Show decay or infection between teeth, under old dental fillings or underneath the tooth enamel.
Signs of groove patterns, white spots, roughness or stain patterns are signs of early decay.
If an area of the tooth is soft or sticky, this is an indication of dentine breakdown.
Allow the patient to review close-up images of their teeth so they understand more clearly.
Modern day fillings involve very little discomfort. Advancements in technology such as suitable anaesthetics and durable tooth-coloured composite materials maximise accuracy, aesthetics, and longevity.
Most dental filling appointments take around 20–40 minutes depending on the size and location of the cavity.
Even when you are not in pain, decay continues to grow. If a small cavity is ignored, it can develop into:
Pain is often the last symptom, not the first.
Some patients are surprised when they develop decay despite brushing regularly and well. Reasons for why this could happen include the following:
Patients often leave plaque on the back molars or in the spaces between the teeth.
Sugary foods and drinks, as well as snacking habits, contribute to the problem.
A dry mouth reduces saliva, which normally neutralises acids and helps repair early enamel damage.
This alters the moisture level of the mouth and promotes the decay process.
Teeth with soft enamel, deeper grooves, or gum recession can increase the risk of decay.
Flossing or using interdental brushes to clean between teeth are essential.
Routine dental hygiene visits can help catch these issues early and see if there is hidden plaque build-up.
Composites or white fillings have overtaken metal fillings to become the filling of choice due to these benefits.
They blend in beautifully with your smile, allowing us to offer aesthetic options for our patients.
Experiencing slight temperature sensitivity after having a filling is a normal and temporary event, and it will usually settle down within the first few days. If the tooth continues to be uncomfortable after a week or more, it may be an indication that the filling needs to be adjusted slightly. Your dentist will be able to evaluate your bite and see how the filling is seating, if the sensitivity continues.
Preventative practices can greatly lower the likelihood of cavities developing:
Good habits today lead to fewer needs for fillings tomorrow.
Cavities often develop silently even without pain and are often hard to detect. The early signs of cavity development can be very subtle – from small brown spots on teeth to rough patches on the surface to slight chips in the surface. Another common sign of decay is the trap of food lodged in the same spot your tooth is decaying, leading you to believe the decay may only be localised there.
Sensitivity to sweets can indicate cavity development as well. You may discover tenderness when eating candy. If you see dental floss catching when cleaning between two teeth, that may be another indication there is a developing a cavity as well. These subtle signs should not be ignored, as early intervention results in avoiding damage to more surface area which can create the need for other surgical intervention.
Cavities are not always painful, but early diagnosis helps avoid bigger complications. If you have not seen a dentist in a long time, this would be a suitable time to book an appointment. You can expect gentle treatment, modern imaging and advanced diagnostics, and great individualised care with a caring dental team at our South Kensington MD.
20 Old Brompton Road, South Kensington, London SW7 3DL
