The purpose of endodontic testing is to determine what treatment, if any, is necessary to eliminate dental disease. Often, it is difficult for patients to explain what they are feeling and where the sensation is coming from. During clinical testing, endodontists try to reproduce a patient’s complaint. This is truly the only way to insure of proper treatment.
What causes dental pain?
Dental pain can originate from many sources:
Tooth Nerve – The dental pulp is encased in layers of enamel and dentin. The pulp consists of a blood supply, supporting connective tissue and nerves. When the nerve becomes inflamed from trauma or infection, it ceases to function properly. Initially, you may feel a sharp, lingering sensitivity to cold and then dull ache when exposed to heat. If left untreated, your tooth may become so sensitive to heat that your own body temperature causes pain. These patients often resort to drinking cold water to relieve pain. Tooth nerves do not have proprioception and it may be difficult for the patient to identify the offending tooth.
Periodontal Ligament – The periodontal ligament is connective tissue located between the tooth and the surrounding bone. Inflammation of this ligament can cause it to swell and force the tooth to rise slightly out of the socket. This change in occlusion exposes the ligament to more traumas during normal function of chewing.
Bone – Infection in the bone from bacteria in the root canal system can cause a dull ache. Unlike teeth, nerves in the bone and periodontal ligament contain proprioceptive fibers and allow the patient to distinguish the location of the offending tooth. Bone pain is often perceived as a dull, ache deep in the jaw.
Gingiva – The gingiva surrounds the collar of the crown and covers the surrounding bone. Bacteria can cause gingival inflammation. Gingival pain can often present as a dull ache unprovoked and a sharp sting when touched.
Andrew Stubbs, DMD is a specialist member of the American Association of Endodontists. He is a graduate of Boston University and maintains an ecofriendly dental practice in Lone Tree, CO. Dr. Stubbs specializes in root canal treatment and provides sedation dental treatment for patients from all over the Denver area.