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Toothache often extends beyond the causative tooth or organ of the oral cavity, leading to diagnostic difficulties. With the defeat of the lower molars, the pain spreads to the temporal, parotid region, ear and lower jaw. With inflammation in the upper molars, pain can radiate to the ear, lower jaw, eyes, larynx, and even the parietal region. When the anterior teeth, canines, and premolars are affected, pain can spread to the forehead, eyes, chin and nose.
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The nature of the pain depends on the depth of the process, with the destruction of the hard tissues of the tooth. A shallow defect with superficial caries, characterized by short-term pain that arises from chemical and temperature irritants and disappears after they are eliminated. With medium caries, when the defect is already deeper, within the dentin, the pain from chemical and thermal stimuli is more prolonged and intense, but also disappears after the stimulus is removed.
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With deep caries, when the process extends to the peri-pulpal tissues, pulp inflammation can occur. According to modern views, in this case they speak of pulp hyperemia, reversible or irreversible pulpitis. With pulpitis, the pain is more intense than with caries. It arises spontaneously, its duration is longer, and over time it becomes almost constant. It is also characterized by an increase at night.
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The pain is provoked by any irritants, and soreness may appear when biting on the causative tooth. Characterized by widespread irradiation along the branches of the trigeminal nerve. In chronic pulpitis, the pain is weaker and is provoked by mechanical and thermal stimuli. Patients often complain of pain in the tooth when they inhale cold air.
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With periodontitis, the intensity of persistent pain depends on the stage of inflammation. Acute pain is characterized by severe aching pain localized in a diseased tooth. It hurts to bite on it. Regional lymphadenitis may appear. Chronic periodontitis is characterized by less bright pain in the area of the causative tooth, accompanied by aches and bursting. In some cases, it can be asymptomatic. With exacerbation of chronic periodontitis, the clinical picture is similar to acute periodontitis. If a tooth is injured, the pulp can be damaged. In this case, the clinic is similar to acute pulpitis. iv
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Now let's try to understand the myths that have developed around toothache. The first reason for such problems is the spread of harmful microorganisms through the root canal of the tooth into the jaw bone. Microorganisms destroy the bone near the root of the tooth, causing inflammation and, as a result, pain. This process can be very fast, or it can take several years.
- How do microorganisms get into the sealed canal? This can happen if during the treatment of the tooth all carious tissues were not removed and secondary caries subsequently developed. From this focus, microorganisms quickly seed the filled canal and then penetrate into the supra-apical space, causing inflammation and pain there. The second reason is poor quality root canal treatment.
- According to modern standards, all the canals in the tooth must be washed, cone-shaped, and very tightly sealed throughout. In this case, favorable conditions are not created for the reproduction of microflora that causes inflammation.
- As we noted earlier, pain signals a malfunction in the body. And even more so a toothache. In some cases, truly healthy teeth can be painful. But these should be very strong irritants, as a rule, thermal: very cold or very hot water.
- Some lovers of contrast drinks drink hot tea or coffee with ice water or ice cream. It may be an interesting taste, but for teeth, even healthy ones, it is a real challenge. Cracks will soon appear on the enamel. Although tooth enamel is considered the most durable material in the human body, there is a limit for it.
- Violation of the integrity of the enamel will lead to the development of caries, the appearance of increased sensitivity of the enamel.
If the tooth ached, and then the pain went away, this is not a reason to postpone the visit to the dentist. On the contrary, you need to do it as soon as possible. Why can a toothache go away without the intervention of a specialist?
Any adverse factors: hypothermia, decreased immunity, chewing overload, can cause an exacerbation. And then the pain will not keep you waiting! Very often this happens at the most inopportune moment: on the road, before an important event, on vacation. Therefore, in order to avoid trouble, contact your dentist for any discomfort, not to mention the pain reaction. The disappearance of pain in a tooth is deceptive, it can entail not only its loss, but also more serious consequences!
Modern dentistry has advanced so far forward that the indications for tooth extraction have been significantly reduced.