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Tooth Nerve Troubles

Your Tooth has Three Main Parts:

The Enamel, which is almost as hard as diamonds, non living, and coats the outside of your tooth.

The Dentine, which makes up the main bulk of your tooth. Dentine is living and is the consistency of hardwood.

The Nerve (or Pulp), which fills up the inside, hollow part of your tooth

The nerve is nourished by blood vessels passing in from the bone at the pointed end of the root. Front teeth usually have one root, side teeth two, and back teeth three or four roots.

Nerve Inflammation

Your tooth’s nerve can become inflamed from a number of causes.

The most frequent of these are:

A crack in your tooth. If it reaches the nerve, bacteria can enter through this crack and cause inflammation.

Decay in your tooth. If the decay is deep enough the decay bacteria can reach the nerve.

A recent repair to a tooth. Everything that is done to mechanically repair a damaged tooth - crowning (capping), bonding, filling etc. have the potential to be the "straw that breaks the camel's back", and cause the nerve to die. The more damaged your tooth is before the repair, the greater is the chance that it’s nerve will die.

A blow to your tooth. A severe knock on your tooth can damage the blood supply to the nerve and cause it to become inflamed.

Pain from Inflammation

When the nerve becomes inflamed your tooth will usually become increasingly sensitive to temperature changes.

In the early stages of inflammation it will be most sensitive to cold. As your nerve becomes more inflamed this sensitivity to cold usually diminishes and your tooth becomes more sensitive to heat.

Eventually the tooth becomes painful and throbs all the time.

An Abscess

After your nerve has been inflamed for some time, it starts to die.

When this occurs, some bacteria and products of nerve breakdown escape through the end of the root into your jawbone and an abscess starts to form.

This abscess is called a Dental Abscess and it is a collection of pus in the jawbone around the tooth.

As more and more pus collects it causes pressure in your jawbone and this produces intense pain.

The pain is increased as you move your tooth or press on it. This is because moving the tooth compresses the abscess - rather like when you press on a pimple, only it is worse.

Initial Treatment

In the early stages of inflammation, sometimes all that it needs is time for the tooth to recover.

In the later stages, the only way to stop the pain and prevent the problem progressing to an abscess is to open into the nerve and put in some antibiotics.

When an abscess has formed the treatment initially consists of opening into the nerve and allowing the pus to drain out.

The long-term treatment for all nerve problems is Root Canal Treatment.

In Root Canal Treatment all the nerve is removed and the space that it occupied is made larger and it is filled up down to the ends of the roots.

See information sheet on Root Canal Treatment.