The most common reason people seek out the assistance of a Bend Dentist is dental pain. Tooth pain originates from the pulp which is located in the middle of the tooth. The pulp contains nerve endings that are extremely sensitive, to pain and vibration, proprioceptive, and hot and cold. The pulp of a tooth can become irritated and painful from: infection, decay, trauma like a chipped tooth, and gum disease.
Dental pain can be associated with both tooth and jaw pain. Many patients state that the pain is worse with chewing, drinking very hot or cold beverages, and with changes in altitude. Some also notice bleeding and swelling around the affected tooth especially with brushing. The tooth ache may also cause pain to radiate to the jaw bone, ear, and temporal mandibular joint. Fever may also accompany the tooth pain due to an infection/dental abscess. Sinusitis, ear infections and TMJ problems can mimic tooth pain and a dental professional will help distinguish these from each other.
Dental carries, most commonly referred to as a “cavity”, this defect in the enamel of a tooth is due to the infection caused by the bacteria Streptococcus Mutans. The bacteria hydrolyzes the food remnants left in one’s mouth after eating and this process produces and acid which is highly erosive and causes the “cavity” in the tooth. Both saliva and calcium help reduce the acids destructive action but lack of regular brushing, flossing and professional cleanings help encourage these bacteria.
The patient with dental carries may or may not be aware of the problem. The carries begins as a chalky white spot on the tooth’s surface, which represents de-mineralization, and can proceed to a brown than blackish colored lesion. As the bacteria uses the food left in ones mouth either after eating or from poor oral hygiene, the acid production overwhelms the mouths natural, thanks to saliva and calcium, ability to neutralize the acid and re-mineralize the tooth’s structure.
Once the decay penetrates the enamel, bacteria can gain access to the dentinal tubules which communicate directly with the tooth’s nerve. This then allows bacteria to multiply and create swelling and inflammation within the tooth which is the cause for pain, or in other words a tooth ache. If the early de-mineralization process is aborted early enough, the tooth can be repaired and saved. However, if the lesion turns brown than there is no way to recover that dental tissue and a repair is needed. The repair involves removing all nonviable tooth structure with a high speed drill and replace and seal the defect with a filling material like composite. One the infection and destructed tooth are removed and the defect is filled the tooth pain should resolve almost immediately.
A dental abscess can be a major cause of dental pain. A tooth ache may develop when bacteria enter into a tooth’s inner structure. The bacteria cause tissue destruction and pus then accumulates inside the tooth and its surrounding support tissue. The infection and pus accumulation causes inflammation, swelling, pain and pressure. This then can begin to spread outside of the tooth into the surrounding tissue causing facial swelling and in extreme cases can compromise the airway which is a medical emergency. Dental pain due to an abscess can not only be started by carries but trauma can open a passage for bacteria to enter the tooth. Often the symptoms are unilateral facial swelling, pain, fever, tooth pain caused by direct pressure, warmth, and these tooth pain can sometimes be alleviated by cold compact and Ibuprofen.
Gingivitis is inflammation of the gum tissue which is most commonly caused by poor dental hygiene. Lack of brushing and flossing encourages bacteria to create a bio-film or plaque on ones teeth. In fact, plaque induced Gingivitis is the most common cause of gum disease. Plaque contains bacteria that produce inflammatory chemicals that promote further inflammation and eventual tissue destruction, tissue loss, dental pan and tooth loss. These are called Lipopolysaccharides and are directly destructive to gum and tooth support tissue.
Direct force can certainly be a major cause of a tooth ache. Many times a direct force may disrupt the tooth as well as trauma from chewing a hard foods. the trauma causes a breech in the enamel and dentin which exposes the pulp which is rich in nerve endings. A sports guard can prevent many sports related tooth aches by eliminating direct trauma to a tooth. Trauma can cause a condition called “Cracked Tooth Syndrome”. This is a condition in which the tooth is fractured into the pulp and biting/chewing induces tooth pain and many will avoid chewing on the affected side all together and often this can be diagnosed with an exam and x-ray.
Referred Dental Pain
Referred Dental Pain is a tooth ache that is actually caused by something other than a tooth, but the pain is directed at the tooth. Migraines, TMJ disorders,cluster headaches and sinusitis are just a few extra dental causes of tooth pain. Trigeminal Neuralgia can cause a tooth ache, usually unilaterally. The tooth ache occurs in the distribution of the trigeminal nerve and is due to inflamamtion or direct trauma to this major facial nerve structure.
Temporal Mandibular Joint disorders can simulate dental pain and often the pain is worse with chewing, but direct tapping or stimulation of nearby teeth do not reproduce the pain. Often the TMJ can become inflamed and/or arthritic which can mimic a molar tooth ache.
Treatment of Dental Pain
The treatment will always depend on the cause and finding it is the job of a Bend dentist. Dr DiGiulio will begin the process of offering you a diagnosis and definitive treatment by completing a comprehensive dental history and physical. Most likely a dental digital x-ray will be taken and then a diagnosis can be determined. if a dental carries is the cause of pain then you will be offfered a filling and so on. So if you are having a tooth ache, call Dr DiGiulio today and she will certainly help get you out of pain and on your way to improved dental health.