Common Dental Problems and How to Recognize Them

Common dental problems by symptom

Use this table to narrow down what your symptom most likely means. A dentist needs to confirm it.

Tooth decay (cavities)

Tooth decay is the most common chronic disease in children and very common in adults. Bacteria in plaque turn sugars into acid, which dissolves enamel. It begins as a chalky white spot, then becomes a brown spot or hole. Early decay is painless. Sensitivity to sweets and cold comes next, and deep decay that reaches the nerve causes a constant or throbbing toothache.

Treatment depends on depth: fluoride varnish can reverse very early spots, fillings repair cavities, a root canal treats an infected nerve, and badly broken-down teeth may need a crown or extraction.

Gum disease

Gum disease starts as gingivitis: plaque along the gumline makes gums red, puffy and prone to bleeding. Gingivitis is reversible with better brushing and flossing.

Left alone, it can progress to periodontitis, in which the bone and fibers holding the teeth are destroyed. Signs include receding gums, deep pockets, persistent bad breath, loose or drifting teeth, and eventually tooth loss. About 4 in 10 US adults over 30 have some periodontitis. Smoking and diabetes both raise the risk and make treatment less effective. Treatment includes deep cleaning below the gumline (scaling and root planing), better home care and sometimes gum surgery.

Dental abscess

A dental abscess is a pocket of pus from a bacterial infection, either at the tip of a dead tooth's root or in a deep gum pocket. Expect severe throbbing pain, swelling of the gum or face, a bad taste, tenderness on biting and sometimes fever. Antibiotics alone do not cure it: the source must be drained by root canal treatment, extraction or gum cleaning. A spreading facial swelling is an emergency.

Cracked and broken teeth

Cracks are common in heavily filled teeth and in people who grind or chew ice or hard foods. Cracked tooth syndrome causes a sharp pain on biting, especially as you release the bite, and sensitivity to cold. Small cracks are protected with a crown. Cracks that extend below the gum may need a root canal or extraction.

Worn enamel, erosion and sensitivity

• Dental erosion is enamel loss from acid: sodas, sports drinks, citrus, wine, acid reflux or repeated vomiting. Teeth look glassy at the edges, yellower and shorter.
• Grinding and clenching (bruxism) flattens and chips teeth and can cause morning jaw ache and headaches. A night guard protects the teeth. See tooth grinding.
• Sensitive teeth usually come from exposed root surfaces where gums have receded or enamel has worn. A desensitizing toothpaste used every day for several weeks often helps.

Other common mouth problems

• Dry mouth: caused by many medicines, Sjögren's syndrome, radiation and dehydration. Saliva protects teeth, so dry mouth raises the risk of decay sharply.
• Bad breath: usually comes from bacteria on the back of the tongue and in gum pockets.
• Mouth ulcers: canker sores are painful and heal in 1 to 2 weeks. Any sore lasting more than 3 weeks needs checking.
• Jaw joint problems (TMJ disorders): jaw pain, clicking and limited opening, often linked with clenching.
• Impacted wisdom teeth: can cause swelling and infection of the gum over a partly erupted tooth (pericoronitis).
• Oral cancer: a non-healing ulcer, white or red patch or lump, especially in people who smoke or drink heavily or have HPV infection.

How dental problems are diagnosed

A dentist will ask where and when it hurts and what triggers the pain. They then examine the teeth and gums, tap and press on teeth, test response to cold, measure gum pocket depths with a small probe, and take X-rays. X-rays show decay between teeth, abscesses at root tips and bone loss from gum disease, none of which you can see in a mirror.

Home care while you wait to see a dentist

• Take acetaminophen (paracetamol) or ibuprofen for pain, following the label dose. Do not put aspirin on the gum, because it burns the tissue.
• Rinse with warm salt water.
• Avoid very hot, cold or sweet foods, and chew on the other side.
• Keep the area clean with gentle brushing.
• Use a cold compress on the cheek for swelling.

Preventing dental problems

• Brush twice a day for 2 minutes with fluoride toothpaste. Spit, but do not rinse, so fluoride stays on the teeth.
• Clean between teeth once a day with floss or interdental brushes.
• Limit how often you have sugary or acidic foods and drinks. Frequency matters more than the total amount.
• Do not smoke or use tobacco.
• Wear a mouthguard for contact sports.
• See a dentist regularly. Many people need a checkup every 6 to 12 months, depending on their risk.

Frequently asked questions

What are the most common dental problems?

Tooth decay and gum disease are by far the most common. Others include tooth sensitivity, cracked teeth, worn enamel from grinding or acid, dental abscesses, dry mouth, bad breath and mouth ulcers. Most can be prevented with fluoride toothpaste, cleaning between teeth and regular checkups.

How do I know if a tooth problem is serious?

Swelling of the face or jaw, fever, pain that keeps you awake, a bad taste or pus, and trouble swallowing or opening your mouth suggest infection and need same-day care. A knocked-out adult tooth needs a dentist within an hour. Brief sensitivity is usually less urgent.

Can dental problems affect your overall health?

Yes. Severe gum disease is linked with poorer diabetes control and with heart disease, and untreated infections can spread into the face, neck or bloodstream. Painful or missing teeth also affect eating, nutrition, sleep and confidence.

Why do my gums bleed when I brush?

The usual cause is gingivitis, inflammation from plaque along the gumline. Brushing gently but thoroughly and cleaning between teeth daily usually stops the bleeding within 2 weeks. Bleeding that continues, or that comes with loose teeth or bruising elsewhere, needs a dental or medical check.

Can a toothache go away on its own?

Pain from mild sensitivity or a gum irritation can settle. Pain from decay or an infected nerve may fade because the nerve has died, but the infection remains and can form an abscess. A toothache that lasts more than a day or two should be checked by a dentist.