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• Time of issue:2018-04-10 16:55
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(Summary description)Whatisthemostcommontypeof toothpain?It’sagoodquestion.Ihavebeeninpracticefor25yearsandmostpeoplecomeinwithacertaintypeoftoothpain,whichIamgoingtodescribetoyounow.Thesymptomsareaslightnon-lingeringsensitivitytocold,hotcoffee,icecream,orcoldwater.Ifyoulivesomeplacecold,evenbreathingincoldaircantriggerthepain. Andforawhile,yourteethache,andit’sveryhardtodescribewhereitis.Thepainmaybeononeside,butnotnecessarilyononetooth.Andsometimes,rarely,thepainisspontaneous.But,italwayshastobecoldairorsomethingthatelicitsaresponse.Andit’sneverreallybroughtonwhenyouarebiting.IfIhearthesesymptomsfromapatient,thefirstquestionIaskis:“Whathappenswhenyoudosomethingverysweet?”Ifthepatientsays,“Ohyeah,ithurts,”thenthatrightaway,typically,indicatesthatthisisthekindofpainthatwearegoingtotalkabouttoday—andit’scalledrootpain.Rootpainiscausedwhentherootofthetoothgetsexposed.Thegoodnewsisthatthispainusuallydoesnotmeanadeepcavity.It’snotthepulpunderattackbyawaveofbacteriacominginandinfectingthepulp. WhatCausesRootPain?Alotofusbyage30or35havebeengrindingourteethsomuchthatthesides,thebaseofthetoothwhereitmeetsthegumline—theside,facial,cheeksideofthetooth—haswornaway.It’schippedawayfromallthoseverticalforcesfromtheopposingteeth.Andsothesidesofthetoothstartbreakingofflikeacalvingglacier.Andthatareabecomesverysensitivebecauseitisexposeddentin.Sometimesthegumwillrecedeandtherootbecomesexposed.Andtherootisalwaysalittlebitmorethermallysensitive—andalso,sugarsensitive.So,ifyoueatsomethingsweet,ifyouarehotandcoldsensitiveanditgivesyoualittleshiveroralittlepain,butitrecoversquicklyanditgoesaway,ifyoudon’thaveanyspontaneouspain,you’rejustsittingtheredoingnothing,yourmouthisclosed,youarenotbreathingincoldairandyoudon’tgetspontaneouspain,thenit’slikelyexposedrootpain.Icallitdentinpain.It’stheexposedrootsensitivetotheexternalambienttemperaturesandenvironmentalfactors.