The above images show the cross section of a molar tooth at various stages of the tooth decay process.
You can see that inside of the tooth there is a ‘pulpal system’ which is made up of nerves and blood vessels. These supply nutrition to the tooth.
Image #1 depicts the nerves and blood vessels as many squiggly lines.
The pulp extends from the top of the tooth (the part that you can see in your mouth), all the way down to the bottom of the roots.
The cavity process starts as a small ‘lesion’ in the outer enamel ‘part’ of the tooth, see image #2 above.
Over time, the cavity gets larger, as shown in image #3, as the decay enters into the second layer of the tooth, called the Dentin.
Eventually the bacteria from the cavity enter into the pulp (image #4).
The entry of bacteria into the pulp is what causes the toothache. The symptoms range from temperature (cold and hot) sensitivity to spontaneous pulsating and throbbing pain…a real toothache.
Many people find that their tooth hurts more at night than during the day…usually when they lie down and go to bed.
There is a reason for this: During the day, you’re busy working, being active, moving about, etc. But at night, when you lie down and all is still, your blood pressure and pulse are reduced. However, the nerve (pulpal) tissue is still irritated and symptomatic (no different than it was during the day).
Because we’re active during the day, we don’t feel the toothache as much, but when all is still and calm at night, then this is when you feel the pain.
1) The bacteria (from the cavity) have entered into the nerve. This is when you experience the real symptoms of a toothache
2) The bacteria continue to move down the pulpal system into the roots of the teeth. Eventually, the bacteria exit through little holes at the end of the roots and this results in severe pain…but why?
3) Because the infection has entered into the bone that holds the roots of the teeth in. The bone is very dense. Try to imagine something trying to expand in a cement block…severe pressure. It’s the same principle; infection trying to expand in a cement block, which is actually dense bone.
Unfortunately, it is usually this intense pain which brings the patient into the office…the dreaded toothache.
In most cases, we can get you out of pain at the same appointment that you visit the office.
Whether we’re able to treat the tooth, or simply place you on an antibiotic and pain medication, depends on how symptomatic the tooth is, and if there’s a swelling involved.
If we’re able to treat the tooth, then we do so through a procedure known as a Pulpotomy or Pulectomy.
Stay tuned to find out more about treating a toothache.
Toothaches are no laughing matter. They can be debilitating. For pain-free relief of toothaches and other dental emergencies, give us a call at 905.791.3867. You’ll be glad you did.
About Dr. Robert Axelrad
Dr. Robert Axelrad is a Brampton dentist who owns and manages his own dental practice in Brampton, Ontario. Affectionately known as ‘The Gentle Dentist‘, his patients include children, adults and seniors from Brampton and across Mississauga and the Greater Toronto Area (GTA). Dr. Axelrad recently moved his practice to its current, state-of-the-art dental office at Bestgate Professional Center in in 2002 to accommodate his growing list of happy patients.