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Tooth pain: What + When + How = Why

Updated: Aug 24, 2022

Are there differences in types of tooth sensitivities and does it always mean I have a problem with my tooth or teeth? A common question we might get from patients.

When people ask about tooth pain I always explain, Teeth have limited skills at communicating, they can only hurt. When they hurt, how they hurt and what stimulates them to hurt is the only information as to why they are hurting and, for that matter, what needs to be done to stop them from hurting.

If a tooth is sensitive when exposed to hot, cold or sweets, then those problems are consistent with dentin Hypersensitivity, which usually occurs because the root surface/neck of the tooth is exposed to the oral environment instead of being covered with a protective barrier of gums. Usually, in the case of dentin hypersensitivity, the gums have receded because of excessive brushing or periodontal disease. As a note, usually the teeth hurt more with cold than with hot, mostly because we can eat and drink things that are a lot colder than our mouth temperature, than we can eat or drink things a lot hotter than our mouth temperature. But you need to be aware, temperature sensitivity can also mean very deep decay and the tooth is in danger of dying and needing a root canal.

Spontaneous pain, a little toothache the just seems to happen and then go away is the sign of a dying tooth (irreversible pulpitis) or the sign of a tooth that died silently a while ago (or the person was able to ignore the pain during the dying process) and the area around the tooth root is now infected. It usually aches for a bit and then goes away, but eventually, if you don’t take care of it, it will become a full blown “toothache”, with the swelling and pain commonly associated with a dental infection.

If the dental pain is elicited by chewing and if it is on multiple teeth, unusually on one side of the mouth or the other, then the cause is often from grinding your teeth. The pain often occurs in the morning, if you are a night grinder or in the afternoon, if you are grinding and clenching during the workday. And,speaking of workdays, often, the teeth do not hurt on weekends, because you are not stressed on weekends.

A sharp pain that occurs when you bite down just hard enough and sometimes just at a specific angle on one tooth is most commonly a sign of a cracked tooth. That kind of pain can go on for years and patients will often ignore it or switch to chewing on the other side of their mouth, but the tooth is still cracked. It will never mend. It needs a crown to tie all the parts together.

Some serious dental problems have no pain until it is too late to solve them, those are usually dental decay and periodontal problems. That is one of the many reasons to see your dentist or hygienists on a regular basis, so such problems and the many reasons for dental pain, can be prevented.

I hope you enjoyed this dental tidbit. As a dentist or hygienist I suspect you were aware the information, but for most patients it is definitely new news.

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