Teeth Rotting From the Gums: What Are Your Options?

February 7, 2024
Dr. Joe Xanthopoulos

Rotting teeth is a serious dental problem that can result in a range of physical and psychological health issues. Advanced tooth decay can significantly affect a person’s quality of life by interfering with day-to-day activities and causing pain, infection, and low self-esteem.

In most cases, tooth rotting coincides with gum disease. If you’re suffering from tooth decay, you may assume that your teeth are rotting from the gums; many patients believe it’s the gum disease that has caused the teeth to rot. However, while gum disease can accelerate tooth rotting, the decay actually begins with the tooth itself.

In this guide, we take a look at the stages of tooth rotting and the different treatment options you can consider. Tthere are a range of effective treatment options that will get you back doing what you love, with a smile you love.

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Teeth Rotting From the Gums: The Stages

Tooth rotting essentially occurs over a six-stages.

While it may seem like your teeth are rotting due to infected gums, your infected gums are actually likely a result of untreated early-stage tooth decay.

Tooth rotting and gum disease are the last two stages of the tooth decay progression.

Let’s take a look at how tooth decay progresses from plaque build up to teeth rotting and diseased gums.


Stage 1: Tooth Plaque and Demineralisation

The first signs of tooth decay are plaque build up and demineralisation.

The tissue lining the outer layer of the tooth is called enamel. Enamel is the hardest tissue in the body. It’s made up of several different minerals.

All of us have bacteria living in our mouths. This bacteria creates a film that sits over our teeth, which is called dental plaque. The bacteria in our mouths feeds on the sugars from the foods and drinks we consume, which causes a build up of plaque.

When bacteria feeds on these sugars, it produces an acidic substance that eats away at the tooth enamel.

When this happens, the enamel begins to lose its minerals. This process is known as demineralisation.

At this point, a white spot will appear on your tooth. This signals the enamel has experienced mineral loss and is the very first sign of tooth decay.

These changes are very subtle, so you may not notice them taking place.

That’s why it’s important to keep up with biannual dental checks. Your dentist will be able to identify these early signs of decay and prevent it from progressing further.

Stage 2: Enamel Decay

If demineralisation goes untreated, the enamel will continue to break down.

When this happens, the white spot on the tooth will begin to turn brown. This brown spot is actually a very small hole in your tooth, known as a cavity.

Cavities begin about as small as a pin-prick, but open up into much larger holes beneath the surface of the tooth.

Stage 3: Dentin Damage

Cavities leave the dentin of the tooth exposed.

The dentin is the bone-like tissue that sits underneath the tooth enamel. It’s softer than tooth enamel, which means it’s more sensitive to damage and wears down easily.

This means that when the bacteria and acid reaches the dentin, the tooth decay will progress more rapidly.

The dentin also leads to the nerves within the tooth, so damage to the dentin can cause tooth sensitivity.

This sensitivity is often exacerbated by very hot, cold, or sugary foods and beverages.

So, that sharp pain you get when sipping on a glass of icy water signals that your dentin is breaking down.

Stage 4: Damage to the Pulp

The pulp is the innermost part of the tooth where the blood vessels and nerve endings sit.

These nerves are responsible for keeping our teeth healthy and providing our teeth with sensation.

Once the dentin is erroded, the pulp then becomes exposed to bacteria. When bacteria damages the pulp, the pulp becomes irritated and begins to swell.

The surrounding tissues cannot expand enough to provide space for the swelling, which means pressure is placed on the nerves.

This often causes severe tooth pain.

Stage 5: Gum Disease and Abscess

When tooth decay reaches the pulp, this leaves the gums vulnerable to infection.

Gum disease occurs when plaque build-up and bacteria reach the deepest layers of the tooth (the pulp). This irritates and inflames the area.

The milder form of gum disease that will first appear is called gingivits. Gingivitis causes symptoms such as redness, swelling of the gumline, irritation, and bleeding. The disease can also cause gingival abscesses, which resembles a pimple and forms on the surface of the gum tissue.

If left untreated, gingivitis can progress into periodontal disease. This is a serious and severe form of gum disease. Symptoms include gum pain, receding gums, damage to the gum tissue, and blood or pus in between the gums. Eventually — we’ll touch on this later — periodontal disease can lead to tooth loss.

Periodontal disease can also cause a particular type of abscess, known as a periodontal tooth abscess. Essentially, the inflammation around the tooth causes a pocket of pus to form deep in the gum pocket, which is why the abscess will be visible right where the gum meets the tooth.

These abscesses are usually excruciatingly painful and can be very dangerous when left to progress.

Gum Abscess Stages

Stage one is the formation of the gum abscess. As mentioned, it will appear as a pocket of pus at the base of the tooth.

The abscess causes severe pain. Over time, the pain can radiate into the jaw.

The third stage is hallmarked by pain moving through the face and jaw. You may experience a fever and swollen lymph nodes, too.

When left to progress, the infection can spread to the jawbone and other areas of the head and neck, which can cause a range of serious health issues.

Stage 6: Rotted and Black Teeth

During the final stage of tooth decay, the tooth rotting accelerates due to the infection within the gums.

As mentioned, periodontal disease can cause tooth loss.

Before your teeth fall out, you may notice your teeth turn very yellow, brown, or black. Black teeth or black rings around the gum lining is a sign of advanced disease and decay.

Your teeth may then begin to feel loose or wobbly, and eventually fall out altogether.

Tooth loss can cause problems for your jawbone and surrounding teeth. Your jawbone may already be damaged due to gum disease, and tooth loss can further this bone disintegration.

When you’re missing teeth, the surrounding teeth are at risk of collapsing into the open space, which changes your bite. This can cause jaw pain and difficulty eating, which can lead to nutritional deficiencies.

The exposed gumline, particularly when untreated, also leaves the body vulnerable to bacteria and infection.

Treatment Options

If you’re experiencing tooth decay at any stage, it’s important to get it treated to prevent further health issues from arising.

Fortunately, modern dentistry is equipped with the tools and techniques needed to treat tooth decay, even at the most advanced stages.

Your dentist may recommend non-surgical or surgical interventions depending on the severity of your tooth rotting.

Treatment for Stage 1 Decay

If you’re in the early stages of tooth rotting with no evidence of gum disease, your dentist will likely recommend minimally invasive treatment.

They will give your teeth a good clean and remove any plaque or tartar from the gum lining.

They may also recommend scaling and root planing, which is where the surface roots of the teeth are smoothed over. This helps to prevent plaque and bacteria from building up again.

Treatment for Stage 2 to 3 Decay

At this point, you will likely need a restoration to fill the cavities in your teeth.

Direct restorations will be used to treat minor cavities. These are known as fillings and can be completed in one appointment. Your dentist will apply local anaesthetic to numb the area, then removed the rotted part of the tooth and fill the cavity with a resin, acrylic, or amalgam material.

Indirect restorations are required for deep cavities. Indirect restorations include inlays, onlays, bridges, veneers, and crowns made from a composite resin or ceramic material. These restorations often require a few visits to the dentist.

For stage 2 and 3 tooth decay, you may also require an antibiotic in the form of a pill, mouth rinse, or gel.

Treatment for Stage 4 to 6 Decay

When your tooth decay is severe and has progressed to stage 4, 5, or 6, you will likely require surgical intervention.

If your teeth cannot be restored, your dentist will need to extract them. You can then be fitted for a traditional dental implant or All on 4 implant to replace your missing teeth. These implants are crafted from acrylic or porcelain and are a permanent replacement for your missing teeth. Unlike dentures, they are not removable.

You may also require tissue or bone grafting if your jawbone or gum tissue have been significantly eroded. This involves taking tissue or bone from another area on your body (or from a donor) and attaching it to the affected site.

In some cases, it’s necessary to cut into the gum to remove plaque from below the gum line. Minor bone loss can also be repaired during this procedure.

A Note on Children’s Rotting Teeth

Unfortunately, tooth rotting is very common in children.

A number of factors cause tooth decay in children, including poor dental hygiene and a diet high in sugar and carbohydrates.

Whether your child’s primary teeth (baby teeth) or permanent teeth are affected, there are a number of treatments available.

A Final Word

Whether you’re in the early stages of demineralisation or your teeth have begun rotting from the gums, there are treatments available to restore your smile and eliminate your pain.

At Kew Dentistry, we are committed to providing superior dentistry for our patients.

We know dental procedures can be a little daunting, so we’re here to work with you to make the experience as comfortable and seamless as possible.

We’ll talk through your needs in a personalised consultation, and address any concerns you may have.

Our expert dentists have extensive training in providing restorations, crowns, dental implants, All on 4 implants, veneers, and gum and bone grafting.

Have a question about your dental concerns? We’re here to help. Get in touch with us and we can discuss your treatment options.