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Posts for tag: tooth pain

By Dr. James Merlo and Dr. Mary A. Merlo-Murison
January 18, 2016
Category: Oral Health
Tags: tooth pain  
FindandTreattheActualSourceofToothPaintoRelieveit

Determining which of your teeth is causing your toothache isn’t always easy — or even if it’s a tooth at all. The pain could be coming from a tooth, the gums, or both. Only a thorough dental examination can pinpoint the exact cause and best course of treatment.

If a decayed tooth is the problem, the pain may be coming from nerves and other tissue deep within the tooth’s pulp. The symptoms could be dull or sharp, constant or intermittent, specific to one area or spread out. It’s even possible for the pain to suddenly subside after a few days. This doesn’t mean the infection has subsided, but rather that the infected nerves have died and no longer transmit pain. Pain can also radiate from the actual source and be felt somewhere else — the pain in your sinuses, for example, could actually originate from an infected back tooth.

If the source is periodontal (gum) disease, the infection has begun in the gum tissues. As they become more inflamed they lose their connectivity with the teeth, bone loss occurs and the gums may “recess” or draw back. This exposes the tooth root, which without the protective cover of the gum tissues becomes highly sensitive to changes in temperature or pressure. As a result you may encounter sharp pain when you eat or drink something hot or cold, or bite down.

Treating these issues will depend on the actual infection source. An infected tooth often requires a root canal treatment to clean out the pulp and root canals of dead or infected tissue, fill them with a special filling, and seal and crown the tooth to prevent future infection. If the source is gum disease, we must manually remove the bacterial plaque causing the disease from all tooth and gum surfaces to stop the infection and allow the gums to heal. In advanced cases, surgical procedures may be necessary to repair damage and encourage new gum and bone growth.

Where dental disease has spread from tooth to gums or vice-versa, you may need treatments for both areas to address your overall condition. Whatever the treatment course, we can put an end to your tooth pain and restore health to your teeth and gums.

If you would like more information on the sources of mouth pain, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Confusing Tooth Pain.”

By Dr. James Merlo and Dr. Mary A. Merlo-Murison
January 13, 2015
Category: Dental Procedures
AcuteToothPainmaybeSignalingYourNeedforRootCanalTreatment

We now have amazing therapies to replace lost teeth with life-like replicas that look and perform like real teeth. But for oral health in general it’s still better to save a natural tooth if we can.

That’s the main purpose of a root canal treatment — to rescue a tooth whose pulp (an area of tissue and nerve bundles inside the tooth) has died from trauma or ravaged by a bacterial infection that continues to progress up into the bone via the root canals. By accessing the pulp through a small opening in the top of the tooth we remove the dead and infected pulp tissue, thoroughly disinfect the empty pulp chamber and root canals, and then fill them with a special filling. We then seal the opening (and later install a permanent crown) to prevent future fracture of the tooth and re-infection.

So, how can you know your tooth is in danger? Your first indication may be an intense tooth pain that comes on quickly. This pain is emanating from the nerves in the pulp as the tissue begins to die. Once the nerves have died, they will no longer transmit pain signals: hence the pain will subside rather quickly in about two or three days.

So it is important to understand that the absence of pain doesn’t mean the infection has subsided — quite the contrary, it’s still present and active, making its way along the root canals of the tooth. At this point you may begin to notice a secondary pain when you bite down on the tooth. This is originating from other nerves located around the periodontal ligament (the main tissue that helps hold teeth in place with the bone) as the tissues become inflamed from the infection. You may also develop an abscess, an area in the gum tissue where infectious pus may collect. Depending on its location, the abscess can be acutely painful or “silent,” meaning you may not feel any pain at all. The infection is still there, though, and the tooth is still in danger.

If you encounter any of the pain symptoms just described, you should visit us for an examination as soon as possible. If the cause indicates the need for a root canal treatment time is of the essence — the longer we delay, the greater the risk of ultimate tooth loss.

If you would like more information on root canal treatments, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Signs and Symptoms of a Future Root Canal.”

By Dr. James Merlo and Dr. Mary A. Merlo-Murison
April 04, 2013
Category: Oral Health
Tags: tooth pain   sensitive teeth  
GettingtotheRootofToothSensitivity

An icy cold beverage on a hot day or a steaming cup of cocoa on a frigid day are some of the simple pleasures in life. So why do they sometimes seem to turn against you and send sharp, sudden pain shooting through your teeth?

When pain affects your teeth, it's because the nerves within the very center portion, the “pulp,” are reacting to a stimulus such as temperature, pressure changes, or acidic or sugary substances. In healthy teeth, the pulp is protected from stimuli. Above the gum line, a layer of enamel encases and protects the visible portion of tooth (crown). Below, the gums (gingiva) and a thin layer of “cementum” protect the root portion. Neither of these contains nerves. However, directly under the enamel and cementum, surrounding the interior pulp, is the “dentin.” This layer contains nerve fibers that can relay sensations to the nerves in the pulp, which respond as they are designed to — with an unpleasant feeling that tells you something's wrong.

That feeling can range from a momentary pang, to prolonged dull throbbing, to downright excruciating distress. The nature of the pain depends on the type and degree of stimulus. The only way to be certain of what's causing the pain is with a professional dental examination. However, your symptoms can hint at some possible sources.

Fleeting sensitivity triggered by hot and cold foods generally does not indicate a serious problem. It may be due to any of the following:

  1. a small area of decay in a tooth,
  2. a loose filling,
  3. an exposed root surface resulting from gum recession (often due to improper or excessive brushing), or
  4. temporary pulp tissue irritation from recent dental work.

To help alleviate root sensitivity, make sure the tooth is free of dental bacterial plaque by brushing gently no more than twice a day. Fluoride-containing toothpaste made for sensitive teeth might help. Fluoride and additives such as potassium nitrate or strontium chloride help relieve sensitivity. Try using the toothpaste like a balm, gently rubbing it into the tooth surface for about 10 minutes. If the sensitivity is related to recent dental work, it should resolve within a few days to a week or two, depending on the extent of the work you had done. A mild over-the-counter pain reliever may help in the meantime.

No matter what the reason, if the sensitivity persists or worsens, please come see us. Together we'll get to the root of the underlying problem and resolve it so you can get back to enjoying the foods and beverages you love, no matter what the temperature!

If you would like more information about tooth sensitivity and ways to prevent or treat it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Sensitive Teeth” and “Tooth Pain? Don't Wait!