What does a cavity look like? [Symptoms in Kids + Adults]

Posted on February 16, 2021

Cavities, also known as dental caries, are holes that form in teeth when tooth enamel is eroded by acid.

According to the CDC, more than 80% of Americans will have at least one cavity by the time they are 34. Cavities are amongst the most prevalent chronic diseases that affect people of all ages, but they are especially common in children. In fact, they are the #1 chronic disease in children in the US.

What causes a cavity? A cavity is a hole in a tooth (tooth decay) that can be brought on by a number of things, including a nutrient-deficient diet, frequent snacking, bacteria in the mouth, poor dental hygiene, demineralization of teeth, mouth breathing, genetic factors, and consumption of sugary/acidic food and drink.

Specifically, certain types of food particles break down into sugars and feed bad bacteria on the teeth, which then excrete acid. That acid can eventually build up into plaque and tartar and begin to decay tooth enamel and dentin.

When cavities are ignored, they can lead to bigger problems including painful toothaches, spreading infections, or even a root canal or tooth extraction.


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If you suspect you or your child has a cavity, don’t hesitate to visit your dentist right away. Hopefully, the cavity may be reversible. But either way, the sooner you address the tooth decay, the better!

How can you tell if you have a cavity? You can tell if you have a cavity if you have signs of tooth decay including pain, sensitivity, or visible marks on your tooth. But often, smaller cavities have no symptoms and can only be diagnosed through a dental exam or with dental x rays.

Let’s take a closer look at the signs of a cavity possibly brewing in your kiddo’s mouth.

what does a cavity look like with advanced carriers

Signs of a Cavity

Cavity symptoms can vary depending on the size of the cavity as well as the location of the cavity in your mouth. Symptoms do tend to get worse as the cavity progresses.

It’s not hard to find a “do I have a cavity” quiz online, but you can also consider whether or not you have any of the cavity symptoms below.


A tooth (or multiple teeth) with decay is noticeably more sensitive to temperature changes. If your child consumes something hot or cold and complains of sensitive teeth, it may be a cavity, especially if this sensitivity is newly developed since their last dental checkup.


What does a cavity feel like? A cavity can feel straight-up painful! Your tooth may actually ache. The pain will likely get worse when you consume things that are hot or cold. Sweet foods and sweet drinks may result in pain as well. Spontaneous pain, especially at night or during sleep, is a tell-tale sign, too.

The longer a cavity is ignored, the worse the throbbing or aching can become.

Swollen and/or Bleeding Gums

The gum area around the tooth of concern may appear red, raw, or inflamed. This change in gum texture will be most apparent near the gum line. Gums may bleed as well. Very often, swollen gums resembling a pimple or bubble can indicate a dental infection or abscess and indicate a call to a dentist ASAP.

what does a cavity look like with white spots and discoloration

White, brown, or black spots on a tooth

Can you physically see a cavity? Yes, it is possible to visibly see a cavity and it can appear in the form of a spot or discoloration on your tooth. If you notice a spot on a tooth — whether it be white, brown, or black — this likely could be a cavity.

Hole in the tooth

See a small hole in one of your child’s molars? If you visibly see a hole in your child’s tooth of any size, this is a red flag to make an appointment with the dentist. I encourage parents to look into their children’s mouth’s regularly, especially by lying children back for brushing and flossing because you will have a better view of what is happening in your child’s mouth. Some parents even bring out headlamps occasionally for a better view!

Halitosis (bad breath)

Does your child have bad breath even after brushing and flossing their teeth? This may be a sign of a cavity brewing. It can also be a sign of gingivitis (gum disease) in children and adults or an issue in the back of the throat or with a child’s sinuses, indicating a possible visit to an ENT.

It’s important to remember that your kiddo can have a cavity and not show any of these symptoms, which is why regular dental checkups are vital. Often, only advanced dental disease will cause symptoms.

what does a cavity look like with demineralization, white spots, incipient and staining

What do cavities look like when they first start?

Here’s what to look for on your kiddo's teeth:

  • A chalky or whitish appearance on tooth enamel
  • A white spot on a tooth
  • A tannish, brown or blackish dark spot on a tooth
  • A tiny hole in a tooth

How to Reverse Cavities

Can a cavity go away on its own? Yes! The good news is that teeth can repair and heal, just like bones, so it is possible to reverse a dental cavity.

Made up of 96% minerals, teeth are the strongest tissue in the human body. They are porous, which allows them to lose minerals (but also to absorb them!). The sooner you catch a cavity and make efforts to reverse it, the better.

Wondering how to prevent cavities or reverse them if they’ve started? These are some of my top diet and lifestyle changes to start practicing today:

1. Fat-Soluble Vitamins

Fat-soluble vitamins D3 and K2 are crucial to optimal dental health in children (and adults).

Vitamin K2 plays a key role in the development and maintenance of healthy tooth enamel (outer layer of teeth with no living cells) and dentin (inner layer of teeth with living cells) immune response. Without vitamin K2 , calcium can’t be adequately processed in kids’ bodies and won’t efficiently strengthen teeth.

K2 can be hard to get in the diet, but egg yolks and grass-fed butter are a great source for kids without an egg allergy. I also like Carlson Kid’s Super Daily K2, which is a dairy-free, vegetarian liquid supplement. It’s an easy way to ensure vitamin K2 intake by putting a drop in food or a drink daily.

Vitamin D3, “the sunshine vitamin”, assists in the absorption of calcium. Foods high in vitamin D include salmon, egg yolks, sardines, and cod liver oil.

If you have trouble getting your child to be a fan of vitamin D foods, I also like Renzo’s Dynamite D3. It’s a tasty, green apple flavored tablet that is vegan, sugar-free, and has no artificial sweeteners. Totally parent and kid-approved!

Looking for a D3 and K2 together? My new favorite combo is Mary Ruth’s D3/K2 which is what I give my own girls daily.


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2. Bone Broth

Thankfully, it’s often not hard to get kids to eat and enjoy soup. Make the base of that soup bone broth, and you’re providing them with benefits galore including remineralization and stabilization of teeth.

I always recommend making your own bone broth, but as a working mom myself I don’t always have the time. Kettle & Fire’s Bone Broth is organic with a variety of yummy flavors. Many local farmer’s markets will have premade options, too.

3. Xylitol

A natural sweetener found in the fibers of fruit and vegetables, xylitol stimulates salivary flow which reduces the risk of tooth decay, strengthens teeth, and inhibits the growth of dental plaque.

You can look for toothpaste and mouthwashes that contain this anti-cavity ingredient. Plus, most sugar-free chewing gums contain xylitol. I do advise using this in moderation as we are learning more about how alternative sweeteners may disrupt our gut microbiome. More research is needed.

4. Beverages

Limit sugary drinks — including fruit juice — as much as you can. Opt for water as much as possible and allow only plain water after your child’s nighttime dental care routine.

Milk can be a calcium-rich choice, but again, don’t allow this after teeth have been brushed. The lactose in milk is a sugar that can cling to teeth leading to acidity and possible cavity formation, especially when combined with food particles and plaque left on teeth with perhaps an unideal hygiene routine.

I recommend plain A2 or grass-fed, grass-finished milks, or goat milk which are easier to digest and more abundant in K2 (as well as other nutrients).

It’s important to know that a dry mouth is just as dangerous to teeth as eating sugary candy. Better hydration can make a huge difference when addressing dry mouth, along with optimal nasal breathing.

5. Remineralizing Toothpaste

A remineralizing toothpaste, especially with an “iffy” diet, can be a make-or-break ingredient to little cavity-free teeth.

Instead of fluoride toothpaste, I recommended hydroxyapatite toothpaste. Hydroxyapatite (HAp) is a form of calcium apatite, also known as calcium phosphate, and is a naturally occurring mineral that makes up our bones and teeth. It makes up over 90% of the foundation of your tooth’s enamel and 60% of your bones.


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Even when lab-created, this important mineral can assist in strengthening, restoring, and even rebuilding your teeth and bones. Specifically, in dentistry, it has become a healthy alternative in toothpaste to fluoride thanks to its natural remineralizing and restorative properties.

In fact, a 2019 study demonstrates how a 10% hydroxyapatite toothpaste was able to successfully remineralize developing cavities and prevent demineralization equally as well as fluoride toothpaste.

My favorite HAp toothpaste for kids is Risewell’s Cake Batter toothpaste. For adults, try Boka’s Ela Mint or Coco Ginger toothpaste. They taste great, contain clean ingredients, and can protect your child’s teeth and your own from decay and disease

6. Better Snacking

Kids love to snack, there’s no doubt about that. However, is there a better way to snack? When it comes to dental health, the answer is definitely “yes!”

I always encourage my patients to avoid frequent snacking or grazing. 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 teeth. This makes it more likely that you’ll develop tooth decay and cavities.

Snack smartly by limiting how often children snack between meals and keeping those snacks on the healthy side. Shoot for 2-3 hours between food with only plain water in between as much as possible.

This means saying “no” to foods high in refined sugar, refined flour, unhealthy fats, food dyes and flavorings, preservatives, and starches. These are the ingredients that contribute to the production of plaque and acid within the mouth that attack tooth enamel and over time can cause cavities and other dental health concerns.

As a general rule, it is always best to choose whole foods such as fresh fruits, raw vegetables, high-quality meats and dairy, nuts, seeds, and whole grains.

Is it time to see your dentist?

If your child has signs of a cavity or you’re not sure if that tooth spot is a cavity vs. a stain, it can’t hurt to see your dentist to evaluate the situation. Catching a dental cavity in the early stages is always ideal. Regular 6-month check-ups are still the gold-standard to stay on top of dental health and growth and development, too.

what does a cavity look like with tooth recently sealed

In some cases, you may choose to have dental sealants placed on your child’s teeth to prevent future tooth decay, particularly on the large chewing surfaces of their teeth. While sealants are controversial in biological dentistry, there are safer materials (read: BPA and phthalate-free) that can be used to protect teeth without causing unwanted side effects.

What a Cavity Looks Like On an X-Ray

what does a cavity look like with xray of cavity

Sometimes a cavity doesn’t have symptoms or it may look like a stain, but an x-ray can help get to the bottom of things.

What does a cavity look like between teeth, on the top of the teeth, or on the side? On a dental x-ray, a cavity typically appears as a dark area or shadow on a tooth.

What does a cavity filling look like? On an x-ray, a cavity filling shows up as a brighter spot on a tooth. So it’s not hard to tell the difference between a filling and a cavity on an x-ray.

what does a cavity look like with xray
Na’am, 2016

Preventing Cavities Before They Begin

Prevention is always the goal when it comes to oral health. It’s best to stop cavities from forming to begin with because it will always be cheaper, less traumatic, less uncomfortable or painful, and better for your systemic health to prevent cavities in the first place rather than trying to correct them.

But if your child does get a cavity, do NOT stress! Your pediatric dentist has you covered. We will just work with you as a member of the team to keep your children cavity-free moving forward. Onward and upward!

The tips to reverse cavities can also help to prevent cavities, so don’t forget how powerful diet and daily habits can be when it comes to your children’s oral hygiene! More on cavity reversal strategies coming soon!

As always, consult with your child’s physician prior to any supplementation changes.


  1. Nayak, P.A., Nayak, U.A., Khandelwal V., (2014) The effect of xylitol on dental caries and oral flora. Clin Cosmet Investig Dent, 6 (89-94). Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4232036/
  2. Centers for Disease Control & Prevention. 2016. Hygiene-related Diseases. Retrieved from: https://www.cdc.gov/healthywater/hygiene/disease/dental_caries.html
  3. Amaechi, B.T., AbdulAzees, P.A., Alshareif, D.O, Shehata, M.A., et al. (2019). Comparative efficacy of a hydroxyapatite and a fluoride toothpaste for prevention and remineralization of dental caries in children. BDJ Open, 5 (18). Full text: https://www.nature.com/articles/s41405-019-0026-8
  4. Paszynska, E., Pawinska, M., Gawriolek, M. et al. Impact of a toothpaste with microcrystalline hydroxyapatite on the occurrence of early childhood caries: a 1-year randomized clinical trial. Sci Rep 11, 2650 (2021). https://doi.org/10.1038/s41598-021-81112-y
  5. Naam, J., Harlan, J., Madenda, S., & Wibowo, E. P. (2016). Identification of the proximal caries of dental x-ray image with multiple morphology gradient method. International Journal on Advanced Science, Engineering and Information Technology, 6(3), 343-346. Full text: https://www.researchgate.net/profile/Jufriadif_Naam/publication/304455631_Identification_of_the_Proximal_Caries_of_Dental_X-Ray_Image_with_Multiple_Morphology_Gradient_Method/links/57f467bc08ae280dd0b7461b/Identification-of-the-Proximal-Caries-of-Dental-X-Ray-Image-with-Multiple-Morphology-Gradient-Method.pdf

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