Why toothache occurs

04 / 11 / 2019

Pain is described in the Oxford English dictionary as a highly unpleasant physical sensation caused by illness or injury, and this applies exactly as to why one you may experience pain from your teeth or a tooth.

To understand how this may happen, it is important to understand that a tooth contains billions of nerve endings inside it, in the tissue known as the pulp.

Any irritation to those nerve fibres will result in a pain signal being sent to the brain, and the physical sensation is experienced. The main cause of irritation to those nerve fibres would be if the tooth had a significant amount of decay in it.

If decay in the tooth, caused by a high frequency of sugar intake, were to progress to a stage whereby it advances close to the pulp of the tooth, it would cause those nerve fibres to become irritated and painful.

In its early stages, this can be reversed by gentle removal of the decay and placement of a simple filling or dressing in the tooth.

However, if left unchecked, it can lead to constant irritation and irreversible damage to the pulp.

This leads to the classic all-consuming toothache.

Symptoms classically would be pain that keeps you awake at night, pain bought on by hot food and drinks, and a constant throb that will not go away and not react to painkillers.

Another common cause of pain is if you have had a very recent deep filling in a tooth that previously had deep decay close to the pulp.

The physical action of removing the decay and placing a filling material close to the pulp can, unfortunately, bring on the constant toothache your dentist is trying to avoid! Hopefully, this will not be the case and the restoration placed by the dentist will avoid this.

The next cause of irritation to the pulp of the tooth would be if the tooth had undergone some type of trauma or excessive wear, exposing the dentine or even the pulp of the tooth itself.

The dentine of the tooth makes up the majority of its structure and has tiny channels which can transmit pain signals to the pulp. The main symptom was this to be the case would be a sharp pain to cold food, drinks or even cold wind, the classic highly sensitive tooth.

A minute crack in the tooth may also give similar symptoms, however, these are often under and or around big fillings or even crowns and can be very difficult for your dentist to detect and treat.

Teeth also are surrounded by a structure called a periodontal ligament, which is also teaming with nerve endings.

The main source of irritation to those nerve endings would be infection and irritation, most commonly from a dead or dying pulp inside the tooth.

If the tooth is dead or dying the ligament becomes inflamed and the nerve ending is extremely sensitive.

If they are inflamed and sensitive, the tooth will most commonly be very tender to bite on or even to gently tap on it with a fingernail. This inflammation, if left untreated will often progress onto an abscess which is not only painful but can be potentially life-threatening.

The periodontal ligament nerve endings may also be irritated if the load of the bite on that particular tooth is very excessive.

Other common causes of pain include a poorly healing extraction site known as a dry socket, the fracture of a heavily restored tooth which has eventually failed, resulting in it breaking down to or through the root.

What next?

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