Dental Care

Tooth Nerve Pain

There are very few people who don’t know what tooth nerve pain feels like.

For example, most people have been distracted by a dull ache near or within a tooth, by sharp pain when biting or chewing, or even by fairly constant severe pain and swelling in the gum.

These are all descriptions of dental nerve pain, and they might all have similar, or widely different, causes. Generally, there will always be the need for some diagnostic work before dental pain can be properly treated.

Before exploring dental nerve pain in greater detail, however, let’s first consider the basic anatomy of the tooth to understand the reasons why there are so many different causes for the pain.

Tooth Anatomy 101

Most people know that teeth have two major “structures” which are the crown (the part viewed above the gum) and the roots (the “prongs” that hold the tooth within the jaw).

Either of these areas can sustain damage or weakness which leads to tooth nerve pain.

All teeth are also made of layers of different tissue and contain nerve endings too. It is the nerve endings that allow the tooth to experience the different types of tooth nerve pain, and these are contained in the “pulp” of the tooth.

The outer layer of any tooth is known as enamel, this coats the dentin which lies atop the pulp. Beneath the gum line, there is the cementum and the periodontal ligament which binds the tooth tightly to the bone of the jaw and help with the distribution and use of nutrients too.

What Is Tooth Nerve Pain?

So, how do these various pieces lead to discomfort? Dental nerve pain is usually experienced through the pulp because this is the material that contains the nerve endings, and these nerves are programmed only to sense pain.

Dental nerve pain can develop when inflammation or swelling in the pulp occurs (technically known as pulpitis). This inflammation can come about when a tooth is damaged or cracked, when decay has set in, or when things have gotten far out of control and the tooth has abscessed – which means that the pulp within the tooth is at great risk for tissue death.

Naturally, there are other reasons that people may experience dental and tooth nerve pain. For example, the gum and bone around a tooth can lead to dental nerve pain, the jaw muscles and joints might present pain.

And there is also a phenomenon known as referred pain which is pain being created elsewhere in the mouth, but which is leading a patient to believe that a different tooth is the problem.

Generally, dental nerve pain is due directly to issues occurring within the tooth itself, and which are then causing the nerve endings of the pulp to react and send out their signals to the brain.

What Are the Symptoms?

Interestingly enough, there are many ways that someone might detect the symptoms of tooth nerve pain. For example, they might feel:

  • Pain from the tooth – this can come in the form of sensitivity to hot or cold foods and fluids, small twinges of pain when biting or chewing due to small cavities or old fillings that are exposing the pulp, trauma to the tooth, flawed dental work, or even from receding gums that expose portions of the root; or
  • Dental pain coming from mouth tissue – we visit the dentist for regular cleanings and maintenance in order to keep our smiles bright and healthy, but more importantly, to prevent periodontal disease. This is an issue which causes the gum and bone around the teeth to decrease, and this often exposes the roots to harm. This often leads to an abscess in the root of the tooth, which then causes extreme tooth nerve pain as well.

The dental nerve pain caused by these symptoms is very helpful to the dental professional who is trying to diagnose the issue. If you can indicate the severity of the pain and the general area in which it is detected, they can then pinpoint the problem quickly.

The most important way to gauge your symptoms is simply to note the severity of your actual dental pain. For instance, if the pain seems only moderate or intermittent, or if it actually has a “trigger” such as touching or tapping the tooth, then you have what dental professionals might refer to as “moderate” pain. This is a sign that something is wrong, and it shouldn’t be overlooked. In the next section we’ll discuss the treatments available, but first we need to also mention “severe” pain too.

Severe pain is the “end game” as far as the postponement of dental care is concerned. If you are dealing with continuous and strong pain, swelling in the gum, and even a low grade fever, you are at risk for the loss of the tooth and serious infection. Generally, this illustrates the significance of heading to your dental professional at the very first signs of classic tooth nerve pain.


If you believe that you have only mild to moderate dental pain, it is quite likely that you are in the very early stages of the problem.

For instance, we already know that the tooth contains a lot of different pieces, but it is the pulp that directly impacts pain and nerves.

When something is wrong in the tooth, the pulp tends to get irritated and swollen, which causes serious pressure because it is contained within the incredibly hard surface of the crown and roots. This leads to tooth nerve pain as the end result, and treatment requires that the dental professional find out why the pulp is being irritated.

Your dentist will first diagnose the tooth nerve pain and create a proper treatment plan. If you have a cavity causing the pain (which really is one of the most common causes of pain), most dentists can do a “filling” immediately.

If things are a bit more advanced, they may need more tests to determine if a “root canal”, “extraction”, or even a course of antibiotics is necessary. They might also determine that the pain is related to periodontal disease, an abscess, or a fracture in the tooth.

Obviously, proper treatment is all about correct diagnosis, but it is really up to the patient to control the results of any tooth nerve pain. This means going to the dentist when it is first experienced since tooth nerve pain is always a sign of a treatable problem.


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