Do Dental Cavities Always Hurt?

One of the most common questions we hear, when we first have to give a patient the bad news that they have 1 or more cavities is, “But doc, how come it doesn’t hurt?” It’s a common misconception that a cavity will always give you a toothache.

Cavities Don’t Hurt Until It’s BAD

Today yielded another perfect example of this analogy. A young lady was diagnosed as having a cavity, not because it hurt, but because I could see the previous silver amalgam dental filling had broken, and because we could see it on the x-ray, as shown.

Looking just at the x-ray, you wouldn’t suspect how deep the cavity really is. In fact, studies show that cavities are usually 30% WORSE than they appear on x-rays, because the human eye can not perceive the grayscale changes at the level they really are.

What Does a Cavity Look Like?

If you’ll follow the progression of photos below (and BTW — this work was done by me, not someone else!), you can see where we started with what was a small old filling, then as we progressively and very carefully removed the decay while using 8-12x magnification with a dental operating microscope, to see just how deep the cavity really was. The blue stains are from a solution that we use to help us see where the decay is (it stains the cavity-causing bacteria if there are high enough numbers). Then you can see the finished result: a beautifully natural-looking, tooth-colored composite dental filling. Call our dentists today for more information!

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Laser Cosmetic Dentistry: Fixing a Gummy Smile

September 11, 2026

As I discussed in my last post about Cosmetic Dentistry: Invisalign and a Dental Implant, you don’t always need teeth whitening or porcelain veneers to make a smile more beautiful, nor does it have super expensive, take a long time, or require drilling on your teeth. Sometimes, cosmetic dentistry can be as simple as fixing a gummy smile with laser gum therapy services. Gummy Smiles Don’t Need Veneers – They Need Less Gums! This is honestly one of my favorite kinds of cosmetic dental treatment, but it’s one that many dentists aren’t aware can be done so easily. I wrote about another one of our patients, who still comes in for her check-ups every 6 months like clockwork for the last 5 years), and her Cosmetic Gum Lift, back in 2009. She still can’t believe just how much of a difference it made, and this young lady now feels much the same way. To be completely honest, the change in Tiara’s smile could have been even bigger, but to do so would have required major jaw surgery, and that isn’t something she wanted. But she has been unhappy with her smile for so long, and it’s easy to understand why, right? So what we did is called a “Esthetic Crown Lengthening,” or in normal English, a “gum lift.” Basically, this involves using a laser to recontour the gums (remove the excess) up to the level they should be, and then to gently lift the gums to allow removal of the excess bone that was also covering her teeth. The second part isn’t always necessary, because there’s not always extra bone, but when there is, it’s easy-to-do and painless, because the bone has no nerve endings. A New Smile Fast This photo was taken just 10 days after Tiara’s Gum Lift Procedure, and look what a huge difference it made! She was just ecstatic and couldn’t stop thanking us and smiling. We all know that it’s still not perfect, but she’s not interested in the jaw surgery. But what it is, is a HUGE improvement, don’t you agree?