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Other Causes of Dental Pain
Many conditions can cause pain in and around the mouth. These include (but are not limited to):
Tooth Hyperemia
The hyperemic tooth has an inflamed pulp. It is not yet dead, although it may be on the verge of dying. It will be hyper-sensitive to cold, touch, sometimes sweets. It may be that the patient has a broken filling or cavity and that repair will allow the nerve to settle down. If the tooth is severely painful and the pain is fairly constant, the tooth may be dying. In this case the dentist can start a root canal and that will usually relieve the pain. The best pain reliever for dental pain is Ibuprofen and it's relatives (NSAIDs) if you can take them). Over-the-counter (Advil or store brand ibuprofen), It is sold in 200 mg tablets and directions on the box are to take two every 4-6 hours. This is a very low dose and four, or even six tablets will be much more effective. Cortisone -like products can relieve the toothache temporarily but they must be used carefully and with extreme caution in case these drugs are not indicated for you or you are actually infected (becoming an abscess). Cortisone dampens the immune system and this can make an infection worse.
Root and Dentin Sensitivity
The crown of a tooth is covered in enamel which is hard and has no nerve endings. However, just under the enamel (between the enamel and the pulp, or nerve chamber) lies the dentin and the dentin can be very sensitive since it is filled with little branches emanating from the main nerve / pulp).
Sometimes part of a tooth will lose its enamel covering. This can happen around the gum line where enamel is thin and wears away. If this area of the tooth is touched with a brush or fork, etc., it can be exquisitely sensitive and patients often think that it is a serious problem waiting to happen. In fact, this root sensitivity is common and usually transient and there is no cause for alarm. There are toothpastes for sensitive teeth that are effective but they must be used for a few weeks before one sees results.
Also, when there is wear at the gum line of a tooth, it may be that the patient is brushing too hard. But it is interesting to note that in slow motion photography it is obvious that the tooth is compressed when it bites and thin enamel near the gum can "fly off."
People who grind spots of enamel off the top, biting surface, of their teeth can also feel dentin sensitivity if the enamel is worn through and the dentin is exposed.
SEE A DRAWING OF ROOT SENSITIVITY
"Cracked Tooth" Syndrome
This does not present as an ache and it does not last. Rather, it is a sharp and discrete pain that occurs at the time of biting down on something hard. When the biting is over, the pain stops.
Sometimes a patient will have this type of sharp pain when biting for a long time and then, one day, a piece of tooth actually breaks off and the pain goes away. Why? Because the pain comes from the flexing of the tooth where the crack lies. Sometimes, just a new filling is needed. Sometimes a cracked tooth will need a crown. In a very few cases the crack will extend into the nerve chamber and a root canal will be necessary.
Cracks in teeth are notoriously hard to diagnose and are the dentist's nemesis. If a tooth is cracked in the crown area, often a new filling or crown is what is needed. However, if the tooth has a crack in the root, it may not be diagnosed until the tooth has had a filling, a crown and a root canal that fails (a crack into the nerve or across the root holds bacteria in it and produces inflammation and infection.) Only upon extraction can the crack sometimes be seen. This scenario does not happen frequently but when it does it is frustrating to patient and dentist alike.
(For Mouth Ulcers and Cold Sores see Canker Sore.
Please remember that the information on these site is not all-inclusive and it may or may not apply to your personal situation. For dental advice you need to call your own dentist who needs to actually talk to you and examine you before giving advice or treatment. If, in your mind, you are questioning your dentist, get a second opinion, or a third ...
I do not take new patients and cannot respond to email inquiries or phone calls. Thanks for visiting!
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