About Your Teeth

illustration of a toothA tooth consists of two main parts: the crown, which is visible in your mouth and is contacted during chewing; and the root, which is typically not visible in your mouth and is anchored by surrounding bone and gum tissue. Inside each root are one or more channels that run the length of the root, this is the root canal space. Contained within the canal(s) are blood vessels, nerves, and soft tissue that are collectively called the pulp. The pulp can be irreversibly injured or infected due to deep restorations, decay, fracture, trauma, or periodontal disease. Symptoms of pulpal involvement may include temperature or percussion sensitivity, spontaneous or radiating pain, and swelling.

In order to preserve a tooth in which this has occurred, it is necessary to remove diseased pulp tissue. This procedure is known as endodontic therapy. Since endodontic therapy is concerned with removing only the pulp from the root canal the root will continue to function normally because the supporting tissues remain intact. It is advisable to remove the injured pulp because it may become infected and act as an irritant to the tissues surrounding the tooth.

Tooth Pain Guide

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SYMPTOM:
Momentary sensitivity to hot or cold foods

Possible Problem
If the discomfort lasts only moments, sensitivity to hot and cold foods generally does not signal a problem. The sensitivity may be caused by a loose filling or by minimal gum recession which exposes small areas of the root surface.

What To Do
Try using toothpastes made for sensitive teeth. Brush up and down with a soft brush; brushing sideways wears away exposed root surfaces. If this is unsuccessful, see your dentist.

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SYMPTOM:
Sensitivity to hot or cold foods after dental treatment

Possible Problem
Dental work may inflame the pulp, inside the tooth, causing temporary sensitivity.

What To Do
Wait four to six weeks. If the pain persists or worsens, see your dentist.

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SYMPTOM:
Sharp pain when biting down on food

Possible Problem
There are several possible causes of this type of pain: decay, a loose filling, or a crack in the tooth. There may be damage to the pulp tissue inside the tooth.

What To Do
See a dentist for evaluation. If the problem is a cracked tooth, your dentist may send you to an endodontist. Cracked tooth pain comes from damage to the inner soft tissue of the tooth, the pulp. Endodontists are dentists who specialize in pulp-related procedures. Endodontic treatment, also know as root canal treatment, can relieve that pain.

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SYMPTOM:
Lingering pain after eating hot or cold foods

Possible Problem
This probably means the pulp has been damaged by deep decay or physical trauma.

What To Do
See your endodontist to save the tooth with root canal treatment.

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SYMPTOM:
Constant and severe pain and pressure, swelling of gum, and sensitivity to touch

Possible Problem
A tooth may have become abscessed, causing the surrounding bone to become infected.

What To Do
See your endodontist for evaluation and treatment to relieve the pain and save the tooth. Take over-the-counter analgesics until you see the endodontist.

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SYMPTOM:
Dull ache and pressure in upper teeth and jaw

Possible Problem
The pain of a sinus headache is often felt in the face and teeth. Grinding of teeth, a condition know as bruxism, can also cause this type of ache.

What To Do
For sinus headache, try over-the-counter analgesics or sinus medicine. For bruxism, consult your dentist. If pain is severe and chronic, see your physician or endodontist for evaluation.

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SYMPTOM:
Chronic pain in head, neck or ear

Possible Problem
Sometimes pulp-damaged teeth cause pain in other parts of the head and neck, but other dental or medical problems may be responsible.

What To Do
See your endodontist for evaluation. If the problem is not related to the tooth, your endodontist will refer you to an appropriate dental specialist or a physician.