What Causes Rotten Teeth? [Symptoms, Causes, Treatment, & More]

Posted on March 2, 2021

What your child is eating (think: candy) and not eating (think: probiotic-rich yogurt) can have a direct impact on whether or not you have to deal with rotten teeth. Tooth decay, AKA rotten teeth, is so common in children!

The good news is that it can easily be avoided.

Pictures of rotten teeth can be quite alarming, especially in the late stages. Will rotten teeth fall out? If rotten teeth are not addressed, they can eventually fall out and also cause significant infections and other problems before falling out.

The good news is that you can prevent severe decay before it starts or even early enough to reverse the damage. Yes, a reversal of rotten teeth is possible in the early stages!

rotten teeth

What causes rotten teeth?

Rotten teeth — or tooth decay, dental caries, or cavities, as we dentists call it — can be caused by many factors, including:

Poor Diet

An unhealthy and nutrient-deficient diet is by far one of the main contributors to tooth decay.

Foods high in refined sugar, refined flour, unhealthy fats, food dyes, flavorings, and starches contribute to the production of plaque and acid within the mouth. Plaque, and eventually the tartar it turns into, breaks down tooth enamel and causes cavities and other dental health concerns.

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Frequent snacking or grazing is a major source of tooth decay, resulting in enamel erosion and cavities.

This is because snacking continuously throughout the day means your mouth is mostly in an acidic environment.

Though our saliva helps to neutralize the effects of the acid once we finish eating, snacking too often can overwhelm your teeth. This makes it more likely for you to experience tooth decay and develop cavities.

Try to pick snacking windows to use daily for your kiddos to prevent rotten teeth.


Bad Dental Hygiene

Not taking proper care of the teeth and gums can result in rotten teeth. Brushing, flossing, tongue scraping, and other basic dental care techniques serve as a way to offset the demineralization that leads to cavities.

Ensure your kids (and you!) brush at least twice a day and floss at least once a day. Don’t forget to schedule regular check-ups and cleanings with your dentist (at least two times per year).

Dry Mouth/Mouth Breathing

Have you noticed that your child is a mouth-breather, even without a cold or stuffy nose?

Although this may not seem to be a cause for concern, chronic open-mouth posture or mouth-breathing reduces the amount of saliva and disrupts the oral microbiome within the mouth, increasing the risk of tooth decay gum inflammation.

Dental Crevices

A tooth with a crack or crevice is more likely to become a rotting tooth. Tiny or noticeable dental crevices provide a place for bacteria and acid buildup, which encourages tooth decay.

Sometimes, dental sealants are used for crevices on a tooth’s surface (especially molars) to prevent dental caries.

Unhealthy Oral Microbiome

Your mouth is full of good and bad bacteria. Having an overgrowth of harmful bacteria in the mouth creates a microbiome that is much more conducive to rotten teeth (and many other health problems!).

Those harmful bacteria love sugar. When you consume a lot of carbohydrates or high sugar foods, bacteria produce acid that contributes to the formation of cavities and rotten teeth. The oral microbiome may also become overrun with pathogenic bacteria due to inadequate saliva production or mouth breathing.

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rotten teeth

Symptoms of Rotten Teeth

What do rotten teeth look like? Several symptoms can indicate a rotten or decayed tooth.

Signs of rotten teeth include:

  • a hole in the tooth
  • a white, brown, or black spot on a tooth
  • toothache or sensitivity
  • swelling around the gum line
  • bad breath
  • loss of taste or altered taste in the mouth

If you or your child exhibit one or more of these signs, it’s time to schedule a dental visit!

rotten teeth

Dangers of Rotten Teeth

The scary fact is that rotten teeth affect the body that can go far beyond your mouth. Let’s take a closer look at just how serious advanced tooth decay can be and why you really want to avoid it.

Poisoned Bloodstream

If a decayed tooth becomes infected and is left to rot, it can lead to blood poisoning. This means that bacteria from the rotten tooth infection have entered the bloodstream.

Blood poisoning is a severe infection and requires urgent medical care.


A dental infection can also lead to sepsis, a life-threatening response to an infection resulting in tissue damage, organ failure, and even death.

Seek urgent medical care if you have a rotten tooth and signs of sepsis, including fever, difficulty breathing, low blood pressure, fast heart rate, and mental confusion.

Gum Disease

The increased levels of plaque that cause caries can also contribute to gum disease.

Plaque turns to tartar, and both substances throw the oral microbiome out of whack and cause rampant inflammation — in other words, a breeding ground for bleeding gums.

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Endocarditis or Meningitis

When a tooth becomes infected, a tooth abscess develops in the mouth. An abscess is a pocket of pus around the tooth caused by a bacterial infection.

If not treated, an abscess can spread to the jawbone, the soft tissues of the face and/or neck, and elsewhere. In extremely rare cases, the bacterial infection can travel to the heart, causing endocarditis, or the brain, causing bacterial meningitis.

Loss of Taste or Bad Taste in the Mouth

Infections caused by rotten teeth can actually result in taste loss or dysgeusia, a persistent, unpleasant, or altered taste sensation (sometimes metallic) in the mouth.

According to the National Institute of Dental and Craniofacial Research, taste disorders can be caused by poor oral hygiene and dental problems.

How to Treat Rotten Teeth

How can you fix rotten teeth without going to the dentist? If you suspect advanced tooth decay, schedule a dental visit immediately. However, there are things you can do at home depending on the level of decay and your dentist’s assessment.

Of course, daily oral care is always a must, but let’s look at possible treatment options depending on the stage of rotten teeth.

rotten teeth

Treatment for Early Stages of Rotten Teeth

Can you fix rotten teeth? In the early stages of tooth decay, your dentist may be able to perform a remineralizing treatment or advise you about at-home rotten teeth treatment and remineralization efforts.

Personally, I am a big fan of using biocompatible and non-toxic hydroxyapatite toothpaste rather than fluoride toothpaste for cavity prevention and rebuilding enamel.

Including teeth-healing nutrients like calcium, vitamin K2, vitamin D3, and oral probiotics in the diet and avoiding demineralizing foods (high sugar and/or processed foods) is also critical.

Most of the time, it takes roughly 3-4 months for remineralization to take effect. You may want to take some pictures of the teeth before and after remineralization to document your child’s progress!

rotten teeth

Treatment for Advanced Stages of Rotten Teeth

Treatments for rotten teeth, or teeth that have been significantly decayed, include:

  • Dental filling
  • Pulpotomy (baby teeth) or root canal (adult teeth)
  • Tooth extraction

Unfortunately, not all cavities can be remineralized. When rotting has made its way to the dentin level or is causing pain, it typically cannot be remineralized or treated at home.

Once a rotten tooth is in the more advanced stages, your dentist will likely need to remove the rotten section of the tooth and insert a dental filling.

If decay has reached the center of a tooth and is accompanied by infection, a pulpotomy (in baby teeth) or a root canal (in adult teeth) may be necessary. After a pulpotomy or root canal, you’ll need a dental crown.

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Alternatively to pulpotomy/root canal, your provider may recommend a tooth extraction, which is complete removal of the tooth. If a baby tooth is extracted before the adult tooth is close to erupting, your child will likely need a spacer to maintain orthodontic growth.

Preventing Rotten Teeth

The best thing for rotten teeth is preventing them in the first place.

To prevent tooth decay on a daily basis:

  1. Follow a consistent oral hygiene plan that includes both brushing and flossing. Bush twice a day for at least two minutes and floss at least once a day. Be sure to scrape your tongue.
  2. Eat a tooth-friendly diet. Avoid snack foods high in refined sugar, refined flour, unhealthy fats, food dyes, flavorings, and starches. Instead of sugary foods and starchy foods, choose whole foods with fresh fruits, raw vegetables, quality meats and dairy, nuts and seeds, whole grains, and limited processed food products. Ensure that a healthy, whole foods-based diet includes calcium, vitamin D3, vitamin K2, and probiotics because these all help to naturally prevent rotten teeth.
  3. Have your child rinse their mouth after meals with water and wait at least 30 min before brushing.
  4. Try oral probiotics to balance the oral microbiome. This is particularly important if you or your child have bad breath or are consistent mouth breathers.
  5. Address mouth breathing with your child’s dental and other health providers. Don’t let mouth breathing and/or sleep-disordered breathing wreck your child’s dental and overall health!
  6. Avoid antibacterial products in the mouth, such as mouthwash. These knock out the good bacteria in the mouth along with the bad.

When to See a Dentist

As soon as you notice a rotten tooth, it’s an excellent time to see the dentist. Your dentist (especially if she’s a holistic dentist!) can guide you in reversing tooth decay at home or treat the tooth if required.

If you notice symptoms of open mouth breathing in your child, bring them to your pediatric dentist or pediatrician’s attention. Getting a proper diagnosis and early treatment can often treat the issue before these symptoms worsen and result in long-term medical conditions.

Your oral health and the oral health of your child reach far beyond your mouth. If you notice a rotten tooth, take action quickly to avoid tooth loss and other complications.


  1. Sepsis Alliance. 2021. Dental Health. Retrieved from: https://www.sepsis.org/sepsisand/dental-health/
  2. National Institute of Dental and Craniofacial Research. 2021. Periodontal (Gum) Disease. Retrieved from: https://www.nidcr.nih.gov/health-info/gum-disease/more-info
  3. Cleveland Clinic. 2021. Abscessed Tooth. Retrieved from: https://my.clevelandclinic.org/health/diseases/10943-abscessed-tooth#symptoms-and-causes
  4. National Institute of Dental and Craniofacial Research. 2021. Taste Disorders. Retrieved from: https://www.nidcr.nih.gov/health-info/taste-disorders/more-info

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