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Toothache - Why Won't My Tooth Pain Go Away?

There are many causes of toothache and pain in the area of the mouth. When experiencing tooth pain and/or swelling, it is important to see your dentist to have the area evaluated. The pain and/or swelling is most often related to a disease process that originates within a particular tooth.

The pulpal tissue within the tooth can be irritated by bacteria, external traumatic events, repetitive or extensive dental procedures, or even periodontal disease which can lead to a toothache. When this irritation occurs, the pulpal tissue reacts by becoming inflamed. Since the pulpal tissues and the tissues supporting the tooth have a rich supply of nerve fibers, the inflammatory process can cause pain as these nerve pathways are stimulated. Additionally, the pulp tissue is encased inside tooth structure and it cannot swell and expand in reaction to injury like tissues in other areas of the body. When the injured pulp tissue attempts to swell within the confined root canal space, the pressure buildup can cause a significant toothache.

Pain originating from the dental pulp can be either "spontaneous" or "elicited." Spontaneous pain occurs without an identifiable stimulus, whereas elicited pain occurs only in specific situations. Elicited pain requires a specific stimulus such as drinking cold or hot fluids or biting on the tooth.

As is typical anywhere in the body, the initial stages of a disease process do not always cause symptoms. Millions of teeth have irreversible pulpal disease yet the patients have no clinical symptoms. Most of these situations will become evident when the dentist obtains a thorough history, does a clinical examination, performs specific tooth tests, and takes a series of well-angulated radiographs. It is important to note that pulpal disease can refer pain to other areas within the head and neck.

If the results of the endodontic examination indicate that root canal disease is not the source of the patient's symptoms, then the dentist must consider other possibilities. When attempting to identify the source or cause of facial pain and/or swelling, the dentist must consider that the symptoms could actually originate in a tooth (endodontic disease), the gum tissues (periodontal disease), the muscles (myofacial pain), the joints (TMJ), the sinuses (sinusitis), or even the surrounding vascular (blood vessels) or nerve tissues. Tooth pain requires an accurate diagnosis so that the proper treatment can be recommended. At times, various medical and dental specialists may need to be consulted before an accurate diagnosis can be determined.

By Clifford J. Ruddle, DDS, in collaboration with Philip M. Smith, DDS

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

Root Canal Dentist, Tooth Pain and Endodontic Disease

What Are the Most Common Symptoms of Endodontic Disease?

Endodontic disease can manifest itself with a wide variety and combination of symptoms. Common symptoms of endodontic disease include:

• Lingering tooth sensitivity to cold liquids.
• Lingering tooth sensitivity to hot liquids.
• Tooth sensitivity to sweets.
• Tooth pain to biting pressure.
• Tooth pain that is referred from a tooth to another area, such as the neck, temple, or the ear.
• Spontaneous toothache, such as that experienced while reading a magazine, watching television, etc.
• Constant or intermittent tooth pain.
• Severe tooth pain.
• Throbbing tooth pain.
• Tooth pain that may occur in response to atmospheric pressure changes, such as when flying or scuba diving.
• Tooth pain that may occur in response to postural changes, such as when going from a standing to a reclining position.
• Tooth Swelling.

If you have any of these symptoms, it would be wise to see your dentist because you might have root canal disease or another dental problem.

Some of these endodontic disease symptoms may also be attributable to decay, defective fillings, periodontal diseases, cracked teeth, or other tooth or bite-related problems.

On other occasions, the symptoms may even be caused by disorders that are not related to the teeth.

Why May Endodontic Disease Cause Swelling?

When the pulpal tissue becomes severely diseased and necrotic, the resultant infection can spread from inside the tooth into the adjacent bone and soft tissues. As a result, swelling can occur in the tissues immediately surrounding the tooth.

If this situation is not treated and the endodontic disease process is not kept under control by the body's defenses, the infection can begin to spread into other tissue spaces, such as those around the eye or in the neck. In some situations, this can become a serious medical emergency.

By Clifford J. Ruddle, DDS, in collaboration with Philip M. Smith, DDS

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.