Rachael is a freelance healthcare writer and critical care nurse based near Cleveland, Ohio.

Edmund Khoo, DDS, is board-certified in orthodontics and is a Diplomate of the American Board of Orthodontics.

Rotting teeth can cause sensitivity and pain in the teeth and gums. If left untreated, rotting teeth can lead to infections, and gum disease, which has been linked to systemic infections (those that impact the whole body). Dental decay caught early can be treated, but prevention is the best tool to avoid rotting teeth.

This article will explore the causes of tooth decay, the appearance of rotting teeth, and how to prevent and treat dental disease.

There are more than 700 types of microbes (tiny living organisms) in your mouth. The microbes make up your microbiome, the natural balance of bacteria, viruses, and other organisms in your body.

Some bacteria are good for your body and help break down and digest food. Other bacteria are harmful and can lead to illness or infection. Bacteria and the acids they produce, along with viruses, fungi, and other microorganisms, live in the mouth and, together, create tooth decay.

The sugar and starch in the food and beverages you consume feed bacteria and create a film called plaque on the teeth. Plaque hardens into tartar, which can eat away tooth enamel and gum tissue, leading to tooth damage and gum disease.

Tooth enamel is made up of strong minerals that protect the deeper layers of the teeth. Weakened enamel and exposed areas of teeth from damaged gums are most susceptible to mineral loss, which also contributes to tooth decay.

White spots on your teeth are a symptom of mineral loss and an early sign of tooth decay.

Visible signs of tooth decay also include brown or dark stains, especially around the base of the teeth, and roots that are exposed below the gum line. In severe cases of tooth decay, there may also be noticeable abscesses (pus-filled pockets) or swelling.

You may feel the physical symptoms of tooth decay before any visible signs are recognized.

Symptoms of tooth decay can include:

Several treatment options can help treat decaying, or rotting, teeth. Your dentist will choose an appropriate treatment based on the severity of decay and other symptoms.

Treatments of tooth decay can include:

Although there are several effective treatments for tooth decay, prevention is preferred whenever possible.

You can prevent tooth decay with regular dental care like:

Bacteria, acids, and other substances cause tooth decay by eating away at the enamel of your teeth. Increased bacteria in the mouth can lead to infections, which can be severe if left untreated. Tooth decay can be treated through several methods, but regular dental care is the best way to prevent rotting teeth.

Tooth decay can cause pain and difficulty eating and increase the risk of developing an infection. Once tooth decay develops, your dentist may provide fluoride treatments or fillings to repair the damage.

In severe cases, a dentist will remove the decayed tooth and replace it with an implant. See a dentist for regular cleanings and exams. Be sure to bring up your dental hygiene habits and your risk of developing tooth decay.

In some cases rotten teeth can be treated with fillings or a procedure called a root canal. If rotten left untreated, your dentist may have to remove the affected teeth. You can also develop severe oral or systemic infections.

A dentist can treat rotting teeth with fluoride treatments, fillings, and root canals if you get help before the damage becomes too severe.

Pain, the tooth turning gray, and bad breath are signs of a dead tooth. A dentist may be able to perform a root canal to save a dying tooth. Otherwise, the dead tooth will be extracted.

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American Academy of Periodontology. Gum disease and other diseases.

National Institutes of Health. Mouth microbes.

Linares DM, Ross P, Stanton C. Beneficial microbes: The pharmacy in the gut. Bioengineered. 2016;7(1):11-20. doi:10.1080/21655979.2015.1126015

Vaissier Welborn V. Enamel synthesis explained. Proc Natl Acad Sci USA. 2020;117(36):21847-21848.

Mark A. Options for dealing with tooth decay. J Am Dent Assoc. October 2018;49(10):P927-928.

Dentaly.org. Dead tooth: causes, treatment options and symptoms.

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