Dental neuralgia is the irritation of one of the nerves that innervates all the oral elements. It is manifested by severe pain that often affects one side of the face. Similar to electric shocks, pain occurs during certain stimulation as commonplace as brushing your teeth, drinking or chewing food.
The mechanism of dental pain
The tooth has a central organ, the pulp, which contains both the blood vessels and the nerves whose entry into the cavity is through a very narrow passage. The dental pulp is not extensible at all and is therefore very easily compressed. At the slightest infection or elevation of temperature, vasodilatation occurs which increases the blood supplies and compresses the nerves. These react by sending a signal of pain to the brain .
The famous “toothache”, more scientifically called pulpitis, is triggered by inflammation of the pulp. This is the same phenomenon that occurs with headaches: the cranial box is almost not extensible. Sometimes the pain disappears when the infection becomes chronic, but you have to be very careful: if a tooth does not hurt anymore, there is cause for concern because it may be mortification . Insistent contact with hot or cold should normally continue to cause small pain.
The other “way” of having a toothache is through the dentine , the major constituent of the tooth. It is not vascularized but innervated slightly by tiny nerve fibrils. If we scratch the neck of the tooth, where the email is absent, we can feel this pain.
Email and cement are not innervated. The nerves themselves can be harmed and cause neuritis.
The different dental pains
There are several different pathological pains:
– Acute pulpitis , also called toothache. The pains are very violent and accelerated by the cold, the heat and the supine position.
– Desmodontitis , also called dental arthritis. The pain is more diffuse and intolerable because it does not stop. The nerve in question has little or no response to temperature differences, and more to mechanical pressure or microtrauma (percussion).
– Post-extraction . It is very common for the mandibular nerve, the trigeminal branch, to be bruised, compressed or stretched during extraction of the lower wisdom teeth. This causes pain but no paralysis, and the phenomenon is reversible (in a few days to a few weeks).
Treatment of dental pain
Carie . Cavities that have not had time to reach the pulp of the tooth are easily treated and require only a simple filling. Once cleaned, the cavity is plugged by a filling or a composite.
For damage to the pulp, it may be necessary to devitalize and extract the tooth. A dental prosthesis will then be placed. The pain caused by tooth decay can be relieved with paracetamol (Doliprane, Tylenol, …) or ibuprofen (Advil for example).
Dental abscess . The dentist must perform the appropriate treatment for periodontitis. It devitalizes the tooth, that is to say, it removes the remaining dental pulp; it cleans well the channel in the root then it achieves the canal filling. In the absence of treatment, an abscess of dental origin will evolve and spread to the surrounding tissues. Hospitalization then becomes urgent: it is necessary to drain the infection and to administer antibiotics.
In the meantime, it is advisable to focus on anti-inflammatory drugs that will reduce intra-tissue pressure, and analgesics to a lesser extent. Cloves and red pepper, in complementary treatments, also give good results.