I have tooth pain

Question:

Hi, I have been experiencing some weird tooth pain.  It comes as quickly as it goes and does not seem to last long( a few seconds) and has happened three times in the last 2 days.  It is not a throb pain, more a constant pain if that makes sense.  It feels like someone is touching ice cream to my tooth in the whole tooth but 10x worse, and is one of the worst pains I have ever experienced.  I am going to the dentist, I am just curious on your opinions.  Had a cavity filled in the tooth a couple months ago so not too sure why it would hurt all a sudden.  Thanks in advance.

Answer:

Thanks for submitting your question with us.  Now, the main piece of information that will determine the diagnosis of your tooth is:

Is the Pain provoked?

• Does the pain have a trigger point?  For instance, is it painful when you eat hot or cold food or drinks.
• Does the pain occur sporadically and unprovoked?  Does the pain come and goes as it pleases with no trigger point?  For example, the tooth becomes painful randomly throughout the day.
• Does the pain come when you bite down into food?  Or does the pain come when you open your mouth after biting down on food?

You’re probably wondering, why all the questions?  But believe it or not, answers to these simple questions can guide us down the right path to a correct diagnosis.  Let’s examine each answer:

Yes, the pain is provoked by eating cold/hot food or drink.

Then you have reversible pulpitis.  This means that you have slight inflammation of your pulp inside of your tooth.  This is caused by

• Bacteria/decay
• A recent deep filling without a protective base (Deep restorations need a protective layer underneath it to protect the tooth nerve/pulp)
• Recent deep cleaning

Reversible Pulpitis Treatment

Luckily, this can be easily treated by making a slight adjustment to the filling

No, the pain is not provoked by anything and occurs on its own

You may have irreversible pulpitis.  This means the pulp is damaged beyond repair.  This means that bacteria have leaked into your tooth nerve/pulp and are now irritating the tooth and needs to be removed to avoid serious infection.  Some signs of irreversible pulpitis include:

• Spontaneous, unprovoked pain
• On and off pain
• Continuous pain
• Pain lasts even after food/drink/or stimulus is removed
• Lying down or bending over produces pain

Irreversible Pulpitis Treatment

The treatment for irreversible pulpitis is a root canal treatment.

I feel pain when I bite down

Again, this indicates reversible pulpitis and can be treated by adjusting your filling.

I have pain when I open up after biting down

This indicates a fracture of the tooth.

Fractured Tooth Treatment

Treatment for this depends upon the extent of the fracture and can include anything from a new filling, or a root canal, or even an extraction.

For more information on tooth pain, check out our article here.

Also, see below for a descriptive chart of how to diagnose tooth pain.

We hope this helps and good luck,

Save My Smile Team

My tooth hurts when I eat hot or cold food or drinks

Question:

My tooth hurts whenever I eat hot or cold food or drinks.  If feels like a sharp pain, then it goes away.  What does this mean?

Answer:

This is a sure sign of reversible pulpitis.  The feeling that you are experiencing is caused by exposed dentin.  Remember that dentin is normally covered by enamel (see article on tooth anatomy), if for some reason a portion of dentin is left uncovered, you will usually feel sensations of short, sharp pain when exposed to hot or cold substances.  Exposed dentin can be caused by a cavity, a defective filling/restoration, or recent dental work.  The good news is that this problem can be fixed easily, the dentin just needs to be covered.  Your dentist will be able to give you a filling, simply fix your existing filling, or a pulp cap if necessary.  However, don’t wait too long.  Reversible pulpitis, if left untreated, can turn into irreversible pulpitis.  Unfortunately, irreversible pulpitis can only be treated with root canal therapy, which costs a lot more in the end.  So be sure to act now by visiting your dentist.

Good luck!