Most of us have experienced some form of toothache, and some time in a very excruciating way.
But what are the main causes and what is the right treatment?
When a tooth is decayed, the vital part of it, called dental pulp, becomes inflamed. The level of inflammation depends on how deeply the caries has advanced into the tooth. A superficial cavity causes minor symptoms, such us increased sensitivity to hot, cold and sweet stuff. It is important not to underestimate this mild discomfort, which is a sign of an initial pathology of the dental pulp: a reversible pulpitis. Most of the times a simple filling will resolve the problem. If left untreated the process progresses toward the next stage, the irreversible pulpitis. Here the real trouble starts: toothache, throbbing pain, not well localized, often unbearable. It is due to a dramatic increase of the blood pressure into the dental pulp, a final attempt of the body to get rid of the bacteria, recruiting all the immune system defenses in the affected area. Unfortunately the tooth is like a rigid box and cannot expand. The increased amount of blood compresses the nervous fibres that are part of the dental pulp itself. At this stage the dental pulp cannot be saved but needs to be eradicated trough a procedure that we call ROOT CANAL TREATMENT. The first step, often performed as an emergency, includes getting the tooth numb, accessing the deepest part where the vital tissue is located, and removing the fraction that is easily accessible. The tedious part is what gives the name to the procedure: removing the tiny pieces of tissue that are inside each root.
If Root canal is not performed, the dental pulp eventually dies, but this infected tissue harbour a lot of bacteria and toxins that gradually tend come out of the roots and colonize the surrounding bone. At a one point they can trigger another acute conditions, a periapical abscess, with severe symptoms and pus formation in the bone. Usually we have no sensitivity to cold or hot but a well localized tenderness to pressure on the affected tooth, and various degree of toothache. When the pus find a way out of the bone in the soft tissue, we can notice the typical swollen gum, or swollen face, according to the tooth involved and patient anatomy. Again a Root Canal Treatment is the therapy of choice.
It is important to look for the advice of a dentist as soon as possible in presence of even minor symptoms, or even better to get regular check ups in absence of problems, to identify possible trouble at an early stage.