While there are always atypical variations, most pain in the mouth can be described generally in one of 2 ways. A sharp pain, usually described as sensitivity, or a dull aching pain, usually described as a tooth ache.
Sensitivity, a sharp pain that usually resolves quickly when the thing that caused it is removed, is the most common type of tooth pain, which most people have experienced at one time or another. Teeth are mostly made up of dentine, but they have a have a protective layer of a hard mineral called enamel. Sensitivity is the result of compromised enamel, and thus exposed dentine. When a stimulus touches the dentine, most commonlyfoods or beverages that are cold, hot, acidic or sweet, the result is a sharp/sensitive pain.
Generally speaking, sensitivity that resolves quickly is a sign that a tooth nerve in the tooth is alive, but irritated. The longer the sensitivity lasts once the stimulus is removed, the more irritated the nerve typically is, and the higher the chance that the nerve could be irreversibly damaged. If the problemis dealt with swiftly, the irritationusually will resolve and the tooth and the nerve in it will remain healthy and viable.
Some of the main reasons for dentine exposure and subsequent sensitivity are:
- Tooth wear or recession, where either the enamel layer has been worn out or receding gums expose the dentine below the enamel. Sensitivity from tooth wear or recession is usually treated conservatively with sensitive toothpastes, mouth rinses, specialised topical creams, and in more severe cases, small fillings to cover the exposed dentine.
- Tooth Decay, where bacteriahas worked its way through the enamel exposing the underlying dentine. Decay that extends into the dentine will not improve with creams or pastes, and will require a filling. If treated early, only a small filling will be required. The longer it is left to be treated, the larger the filling that will be required, or even a crown. If left for too long and the decay extends to the nerve, a root canal or an extraction may be needed.
- Cracked teeth, when due to excessing forces, a crack in the enamel layer creates a path to the dentine. If addressed early, a relatively small filling that removed the cracked section and reinforces the tooth is possible. The larger the crack, the more extensive the required repair, possibly even a root canal and/or crown, so it is important to have a crack assessed by a dentist as soon as possible. If the crack progresses to a fracture, repair options may be limited.
Regardless the cause of your sensitivity, the earlier your sensitivity is assessed and addressed, the higher the chance that minimal intervention will be required and that your tooth will stay healthy. If a nerve is left irritated for too long, particularly if the cause is decay or a cracked tooth, the higher the risk that the nerve could die, leading to more severe painand the need for more extensive treatment.
If you have any sensitivity, we would recommend you have it quickly assessed with a dentist, who will be able to identify the cause and the appropriate response.
A dull ache can range in severity from mild to severe, but it is described more as a dull, throbbing pain, rather than a sharp pain. Most commonly, a dull ache does not originate from the nerve in the tooth itself, but from nerves in the bone,gums, and other tissues around the toothas a response to inflammation, infection or trauma.
A dull ache is is typically a more constant pain that is more difficult to relieve. The main causes for this sort of pain are:
- Excessive forces on the tooth, which essentially ‘bruise’ the tissues around the teeth. This could be a result of an uneven bite, clenching/grinding habits, trauma (such as biting an olive pit, or being hit in the tooth). These cases are usually easily treated by removing the excessive forces and letting it heal. Where the jaw joint is involved, in cases of uneven bite, clenching, griding or direct trauma, symptoms may also extend to the jaw joint up around the ear. If symptoms persist, beyond a week or 2, consultation with a dentist to assess the problem is recommended.
- Infection from the tooth where bacteria has penetrated all the way into the nerve of the tooth and subsequently the nerve has died. This bacteria can no longer be treated with a filling, and will require either a root canal or extraction of the infected tooth.Pain will usually stay and increase in these cases until the offending tooth has been addressed, and so it is advised you see your dentist swiftly. Additionally, infection can make numbing the area more challenging, so getting onto it sooner rather than later can make the appointment more comfortable.
- Wisdom tooth pain, where an impacted wisdom tooth that doesn’t have room to come through the gums is causing pressure within the bone. The pain from these teeth may come and go from time to time but removing the offending tooth will provide permanent relief.
- Inflammation or infection from the bone and gums around the teeth. Often described as gum disease or periodontal disease, poor oral hygiene leads to the unhealthy gums and surrounding bone. Sometimes this is localised, where a bit of steak may have been stuck between the teeth, and will be tender for a few days, and sometimes it’s more generalised, due to poor old hygiene and/or abuild-up or calculus (tartar). Other factors such as smoking, diabetes, and genetics often play a role, but thorough professional cleaning followed by excellent daily oral hygiene habits will usually resolve these problems.
If you have any dental pain, or would like more information, please don’t hesitate to give us a call on (07) 3379 1328
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