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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.

An Abscessed Tooth Is a Bacterial Infection

Tooth pain is what usually brings someone with a dental abscess into the dentist's office. These teeth infections can be painful affairs, sometimes accompanied by shooting pains up and down the face. Even if you hate going to the dentist, you'll find that abscessed tooth pain is far worse.

Tooth abscesses are often accompanied by swelling in the cheek or oral tissues. However, sometimes abscessed teeth may have no visible swelling or little pain, so it's important not to wait until you're in severe pain to see a dentist.

If you're diagnosed with an abscessed tooth, you generally have two treatment options: get a root canal, or have the tooth extracted. The tooth infection is deep down inside the tooth root, and the only way to cure it is to clean it out.

Root canal treatment lets you save a tooth even when the tooth's root has become infected. An endodontist or root canal dentist will open up your tooth, clean out the infected pulp inside, and replace the damaged tissue with an inert material. Once a dental crown is placed, you're left with a tooth that looks and feels just like all the others in your mouth.

Tooth extraction is also known as "pulling a tooth." Thanks to modern dental anesthetics, it's not as painful as cartoons might lead you to believe. Your dentist will explain your options for replacing the tooth. Some people opt for dental implant surgery, while others choose a dental bridge or partial denture.

+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.