Finding small holes in your teeth can be concerning. Pits, or ‘micro cavities’ indicate enamel damage. Although enamel is the strongest part of the human body, it can be worn down due to ongoing chemical, physical and bacterial damage.

This article gives you all the information needed to understand why enamel has been damaged. We give you a detailed breakdown of the possible causes, risk factors, how dental professionals will identify them and the treatments available.

What Causes Small Holes In The Teeth Due To Bacterial Decay?

One of the most common causes of small holes is tooth decay caused by bacteria. Our mouths are full of millions of bacteria that create a sticky plaque build up.

The bacteria will feed off refined sugars and simple carbohydrates we eat in our daily food. The waste product they produce is harmful acids.

These acids attack the enamel of your teeth stripping away essential minerals. After a period of time the acid will create small holes or cavities.

How Does Acid Erosion Cause Small Holes In The Teeth?

Enamel erosion can cause small holes as the acid directly attacks the enamel without the need for bacteria. The enamel will gradually become thinner from this.

  • Drinking fizzy drinks, fruit juices, sport drinks and iced teas regularly will cause the enamel to soften.

  • Eating foods such as citrus fruits, vinegar dressings and sour sweets will also cause direct damage.

Acid erosion will cause small pits in the enamel.

How Can Acid Reflux Cause Small Holes In The Teeth?

Having an internal problem that causes acids from your stomach to enter your mouth can be very damaging to enamel. Gastric acids have a very low PH meaning they will quickly attack your teeth.

  • Gastro Esophageal Reflux Disease (GERD): Will cause frequent acid reflux which will cause small holes and smooth pits in your back teeth.

  • Frequent vomiting: Morning sickness in pregnancy or eating disorders can cause frequent exposure to dangerous gastric acids.

  • Dry mouth: Not having enough healthy saliva in your mouth means you cannot neutralize internal acids.

How Can Dental Ab-fraction Cause Small Holes In The Teeth?

Applying too much pressure can cause chipping and small cracks to occur in your teeth.

  • Teeth grinding: Applying too much pressure to your teeth whilst unconsciously grinding them at night. This will cause small flakes to appear on your enamel.

  • Clenching: Continuously applying great force to your teeth whilst biting will cause your teeth to bend. Small notches will appear in the neck area.

Over time, the enamel will begin to weaken and become rougher.

How Can Aggressive Brushing Cause Small Holes In The Teeth?

Incorrect brushing can cause the enamel to be worn away.

  • Medium/ Hard Bristle Brushes: Using medium or hard bristle toothbrushes will wear the enamel away over time.

  • Aggressive Horizontal Brushing: Brushing your teeth aggressively with horizontal strokes will cause horizontal grooves and small pits close to your gums.

  • Harsh Whitening Toothpastes: Using very harsh whitening toothpastes or home-made baking soda pastes will cause the enamel to wear.

How Can Enamel Hypoplasia Cause Small Holes In The Teeth?

On occasions there may be small holes/pits in your teeth due to incorrect enamel formation.

  • Enamel Hypoplasia: Environmental factors or lack of nutrition in early childhood can cause issues with enamel formation. This will leave pits in the enamel.

  • Genetic Disorders: Genetic disorders such as Amelogenesis Imperfecta can cause thin weak enamel. This enamel will have natural small holes and deep grooves.

  • Health Issues During Childhood: High temperatures or severe infections can cause permanent changes to the enamel matrix.

What Are the Common Risk Factors for Small Holes In The Teeth?

  • Eating sugary snacks, sweets and acidic fizzy drinks regularly.

  • Not brushing your teeth twice per day with a fluoridated toothpaste.

  • Not flossing or using inter dental brushes daily.

  • Suffering from dry mouth due to medication or health issues.

  • Grinding or clenching your teeth at night without a mouth guard.

  • Not visiting your dentist every 6 months.

How Do Dentists Identify Small Holes On The Surface?

Qualified dentists will assess how deep the holes are and what caused them.

  • Visual Assessment: The dentist will use magnifying loupes and light touch exploration tools to see if there is any soft decay on the enamel.

  • Digital X-Ray: The dentist will take a low dose of radiation x-ray. This will show how deep the small holes have gone into the dentin.

  • Intraoral Camera: High definition cameras will be used to take pictures of the holes. This will be shown on the screen.

  • Laser Scanning: Using advanced lasers will help to identify any hidden decay within the pits.

What Treatments Are Available For Pitted Teeth?

Dentists will help restore strength to the teeth. They will remove the decay and prevent further bacterial issues.

  • Remineralisation: Dentists will apply a high concentration fluoride varnish to reverse the earliest of pits.

  • Sealants: Thin protective coatings will be applied to your deepest natural pits and grooves. This is done on your back molars.

  • Fillings: The dentist will remove the small decay and fill the hole with natural tooth colored resin.

  • Porcelain Veneer/Crown: If there are many small pits or severe enamel erosion then a custom made porcelain restoration can be used.

How Can You Care For Your Enamel?

  • Brush your teeth thoroughly for 2 minutes twice per day. Use a soft brush.

  • Use a fluoridated toothpaste to help replenish minerals in your weak enamel.

  • Floss between your teeth daily to help remove plaque that causes acid.

  • Drink lots of fresh water throughout the day to help increase saliva.

  • Rinse with water after eating acidic foods/drinks.

  • Wait 30 minutes before brushing your teeth after eating acidic foods.

  • Wear a mouth guard at night if you suffer from teeth grinding/clenching.

  • Visit your dentist every 6 months.

What Are the Frequently Asked Questions About Small Holes In The Teeth?

Can Small Holes In Teeth Heal?

Very early pits in enamel can heal if you use fluoridated products correctly, have a balanced diet and good oral hygiene. However, once the enamel has been breached by bacterial decay there will be a cavity. Only a qualified dentist can clean and fill the hole.

Do Small Holes In Teeth Hurt?

Small holes in teeth often won’t hurt as enamel doesn’t have any nerves. Pain, sensitivity or discomfort whilst eating sweets will only happen once the decay has reached the sensitive dentin.

How Can I Prevent Acid Reflux Damaging My Teeth?

Talk to your GP to help treat your GERD with the correct treatments. Rinse your mouth with baking soda and water after an acid reflux episode.

Are Whitening Toothpastes Safe For Pitted Teeth?

Many toothpastes on the market are very harsh and will cause the enamel to wear. If you have pitted teeth choose a low abrasion toothpaste that will help build up the enamel. Choose one recommended by your dentist.

If you notice any small holes in your teeth you should visit a dental professional. Whether you have small holes caused by bacterial decay, acidic foods, aggressive brushing or internal issues, getting the issue diagnosed early will help to prevent small pits becoming painful and expensive. Be diligent with your daily oral care routine, avoid acidic foods and visit your dentist regularly to keep your enamel strong, smooth and healthy.