Tooth Nerve Pain

Erosion of the enamel can cause tooth nerve pain

Tooth nerve pain can range from mildly annoying to physically debilitating. Working in a range of low-income, rural, suburban, and university clinics, I have seen my fair share of serious complications related to tooth pain.

In areas with low access to dental care it can be nearly impossible for people to have their dental needs met.

The best line of attack is to prevent dental disease and dental trauma from happening in the first place.

Depending on the severity of the pain and its associated symptoms, it can be a quick fix with over-the-counter products like toothpastes and mouth rinses.

Often, however, tooth pain represents some deeper underlying dental problems that may warrant more comprehensive treatment and ongoing care.

Needless to say tooth pain should not be ignored. Generally speaking, pain is a red flag that something has gone wrong. While a little gum recession can cause aching teeth and sensitivity to hot and cold, most severe tooth pain stems from more serious problems like fractures, dental abscesses, or cavities.

Causes Of Tooth Nerve Pain

Tooth nerve pain is caused by inflammation or irritation of the central portion of the tooth, called the dental pulp

Tooth nerve pain is generally caused by inflammation or irritation of the central portion of the tooth, called the dental pulp. The dental pulp contains very sensitive nerve endings that are usually protected by other layers of the tooth, namely the dentin, cementum, and enamel. When these barriers are eroded or damaged, the nerve endings in the pulp of the tooth are exposed to stimulus, causing tooth pain.

Sometimes nerve signals come from areas other than the mouth and "feel" like tooth pain; this is called referred pain. Multiple systems share the facial nerves and can pass a pain signal onto the teeth. This referred dental pain is most common with TMJ issues, chronic ear infections, sinus infections, and heart problems. Conversely, many people with tooth pain actually feel it as ear aches, headaches, or jaw pain instead of as tooth pain.

Common tooth pain causes:

Cavities and tooth fractures can cause severe tooth pain

Gum recession
Gum disease
Food impaction
Erosion of the enamel
Cavities
Fractured teeth
Fractured fillings
Compromised dental work
Car accidents
Sports injuries
Dental tumors
Oral cancer
Persistent infection
Pulpitis, or inflammation of the pulp of the tooth
Tooth abscess
Dental braces, especially after tightening
Recent dental work like fillings, crowns, and root canals
Leaking dental work like fillings, sealants, crowns, or root canals
Habitually grinding or clenching teeth
Habitual ice chewing leading to dental fracture
TMJ issues (referred pain)
Ear issues (referred pain)
Sinus infection (referred pain)
Heart problems (referred pain)

Signs & Symptoms Of Tooth Nerve Pain

Swelling indicates a more serious dental condition

Sensitivity to hot or cold generally represents more mild conditions such as gum recession or exposed roots. If the pain persists 15-20 seconds after exposure to hot or cold, a more serious issue is likely the cause.

Indications of mild tooth sensitivity:

Sensitivity to hot or cold
Sensitivity to sweets
Sensitivity to tooth brushing
Sensitivity to acidic foods and drinks

Indications of more severe tooth pain:

Pain or sensitivity when chewing or upon pressure
Bleeding around the tooth
Pus and exudate around the tooth
Swelling around the tooth
Swollen "bump" (abscess) on the gums near the tooth's root tip
Jaw and face swelling
Fistula, or external drainage of exudates through facial skin
Injury to the tooth or surrounding tissues (gums, ligaments, bone)
Persistent pain or discomfort
Persistent nausea
Inability to chew foods or eat regular meals

How To Get Temporary Tooth Pain Relief

Topical application of crushed cloves can help alleviate tooth pain

For mild tooth sensitivity relief:

Use fluoride-free Sensodyne toothpaste
Listerine sensitivity mouth wash
Crest Sensi-Stop strips
Avoid acidic foods and drinks
Avoid whitening toothpastes
Use an ultra soft toothbrush
Brush using gentle circular motions (not back and forth)

For more severe tooth nerve pain relief:

Eugenol gel or oil applied topically
Topical anesthetics like Orajel (benzocaine)
Topical application of crushed cloves or clove powder
Warm salt water rinse (1 tsp salt, 1 cup warm water)
Apply a salt and pepper paste topically (1:1:1 ratio with water)
Use a Waterpik to dislodge impacted food below the gum line
Take anti-inflammatory medication like Ibuprofen

Signs That You Should See A Dentist

A dental abscess is a serious infection that needs to be handled by a dental professional

Mild sensitivity to hot or cold should not persist longer than 15-20 seconds after the source of stimulus has been removed. For example, if you are sensitive to cold water but the pain goes away rapidly after exposure, this is a sign of mild sensitivity. Generally this type of pain is due to gum recession and exposed roots (dentin.) Over-the-counter products like Sensodyne toothpaste usually alleviate these symptoms. Generally no further treatment is needed.

If you are sensitive to hot, cold, or pressure and the pain persists long after the stimulus has been removed, this usually represents a more serious condition. Aching teeth that show signs of infection (swelling, pus/exudate, etc.) should always be looked at by a dentist or dental specialist. Even if you don't see obvious signs of tooth or gum infection, ongoing serious tooth nerve pain should be handled by trained dental professionals.

Seek dental care right away if you experience ongoing tooth nerve pain. Untreated dental pain and infection can lead to more serious conditions like bone loss, tooth loss, systemic disease, cancer, and in extreme cases death.

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