Have you ever experienced sensitivity to cold or hot foods while eating? How about some discomfort upon biting or chewing? Or maybe your tooth has constant sharp or dull pain. As different as they may seem, all of these are symptoms of a tooth ache and just like the various symptoms, there are also various possible problems that can be causing your tooth ache.
In order to understand why the dental pain occurs it is interesting to know that every tooth is formed by two surrounding layers of hard structure and also has an inner network of blood vessels and nerves that is known as the pulp. In a healthy tooth, the pulp is completely sealed off from the outside environment, but in the event of brake through this natural shield, an inflammation of the pulp could occur and a tooth ache may persist. The most common reasons for a tooth ache are: tooth decay, inflammation of the pulp, a crack in the tooth, or a dental infection.
Tooth decay refers to a cavity formation on the outer layers of the tooth. This typically occurs over time by plaque accumulation (a sticky collection of bacteria that accumulates from sugar and starches). When plaque continues to build up it produces acidity that will demineralize the hard enamel of the tooth, resulting in weak areas and eventually holes in the tooth. Over time the enamel brakes down and that is when a cavity forms. Even though tooth decay is for the most part painless, as the decay spreads towards the inner layers of the tooth it becomes more sensitive. This sensitivity will be felt by the pulp of the tooth.
Inflammation of the Pulp (Pulpitis)
When the tooth decay extends deep into the pulp, reaching the network of blood vessels and nerves, it could become inflamed. The inflammation can lead to pressure could build up inside the tooth and surrounding tissues. Inflammation of the pulp may not only occur from tooth decay, other conditions that could possibly lead to pulpitis are trauma to the tooth or the result of a series of invasive procedures in the past on the tooth. The main symptom of pulpitis is an exaggerated sensibility with various stimulus, mostly temperature related being either cold or hot.
A cracked tooth is a frequent encounter associated with excessive force applied when biting on certain hard objects such as ice or popcorn, it could also be associated with severe clenching, grinding, or trauma to the mouth (such as a blow to the face in sports or a car accident). The American Association of Endodontics had identified five types of cracked teeth: craze line, fractured cusps, cracked tooth, split tooth, vertical root fracture. Symptoms of a cracked tooth may include sharp pain when biting, chewing, or sensitivity with cold, hot or even to sweet or sour foods.
A dental infection will typically occur in association with an untreated deep cavity or pulpitis. As previously mentioned for a cavity and pulpitis, a dental infection will likely begin with a build up of bacteria inside the pulp network. The infected pulp will have only one place to drain – at the tip of the root. The pressure from the draining infection into the surrounding areas will be perceived as constant pain that will likely worsen when chewing on the tooth or even the slightest tap on the tooth. If left untreated, pain may become severe and swelling can occur.
After looking through the different symptoms and possible reasons of a tooth ache, it is important to know that regardless of the source of pain, any ongoing symptoms should be addressed by a dentist for further assessment and treatment that will help relive the pain and save your natural tooth.
Dr. Daniela Bololoi DDS
INTERNATIONAL ASSOCIATION OF DENTAL TRUMATOLOGY
CANADIAN ACADEMY OF ENDODONTICS
AMERICAN ASSOCIATION OF ENDODONTISTS