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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 Procedure - Life’s Darkest Moment?

Over the years, root canals have come to represent the very worst that life can deal you. They seem to be on par with an IRS audit, or an in-law’s extended visit.

The fact is, when you come to us with the very real pain of an infected tooth, a root canal

The job of an endodontist is to clear out the tooth pulp, carefully clean the canal, and seal the tooth against further infection. This may take one or two appointments, depending on how many root canals are involved. Your endodontist will probably prescribe antibiotics until you’re completely healed.

So you see, dentistry isn’t the bad guy when a root canal procedure becomes necessary. When it comes to root canal pain relief, endodontists are the good guys.

+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.