In part two of my 72 part series (just kidding) on tooth pain, I'll be discussing what's going on when your tooth is sensitive to cold...and I mean really sensitive. Major cold sensitivity is defined as pain that is intense and lingers for more than a few seconds. If you drink something cold and have to stop what you are doing to wince for a minute or two, that's major cold sensitivity. To explain what's going on, I'm going to try something a little different in this post: a tale about castles and invaders.
Note: The following analogy requires your imagination to be properly configured and switched to the "On" position.
In medieval times castles were built to help defend villages against invaders. When an invading army arrived on the scene, the entire village would retreat into the castle, the drawbridge would shut, and the castle's heavy brick and stone ramparts would deter the invaders...initially. However, if the invaders were persistent (and just about all were), they would set up a siege and pelt the castle walls with boulders from their catapults -- slowly turning them to dust. This siege could take months. In the end, though, the castle's defenses would inevitably fall, and the invaders would storm its inner sanctums and plunder everything. A lot of fighting and chaos would ensue.
Castle walls? Invaders? Is this the new Jerry Bruckheimer film? Let's break down the metaphor:
-The castle is actually a tooth.
-The villagers are the tooth's innermost nerves and blood vessels (see my last post if you don't understand this part).
-The invaders are the bacteria that cause tooth decay.
Once that bacteria arrives on your tooth and starts its siege, it slowly pelts away at your tooth's very strong outer walls (tooth enamel). But instead of using boulders to slowly destroy your tooth, it uses acids derived from the sugar you eat (think about this little war going on next time you are sipping a 64 oz Big Gulp of Mountain Dew). The destruction of the tooth's wall results in a cavity, and as the cavity grows it moves the bacteria closer and closer to the vulnerable inner part of your tooth. Sometimes, when it's close to the the tooth pulp, mild cold sensitivity will ensue. Regardless, eventually the cavity will break through and the chaos of the destruction of the village and its inhabitants (your pulp) will result in strong tooth sensitivity. In simpler terms, your pulp tissue is being destroyed by bacteria and is beyond the point of saving.
The severity of this pulp destruction due to bacterial infection manifests itself in multiple forms and degrees of pain, and I'll save that for my next post.
Back to the analogy; let's consider the heroic intervention of another army who happens upon this problem in the castle's hour of need, wipes out the invaders in one fell swoop, and leaves the castle repaired as best it can. That would be great, right? But alas, sometimes the army arrives too late, the walls are leveled, the village is plundered. The only thing the heroic army can do is destroy the invaders from within the castle, clean up the destruction, and repair the walls as best it can. Who is this gallant army? You guessed it, it's your neighborhood dentist! And that destruction of the invaders before they level the walls is a filling of course!
But what does a dentist do if this bacteria "levels your tooth's walls" and invades the pulp? That, my friends, requires a root canal - and the repair is a dental crown. Fortunately, the lack of a pulp (remember, all destroyed) actually makes no difference to the function of your tooth.
There you have it! Strong cold sensitivity explained! The moral of this tale? See your dentist if you experience this, as the pain could get worse. Why? That, as they say, is a tale for another post.
-DRS
Northford Family Dental
Disclaimer: All of the information presented in Dr. Sherberg's blogs cannot be used as the sole source of a dental diagnosis. Only a visit to the dentist can provide that.
Saturday, January 23, 2010
Thursday, January 21, 2010
Hilarious Dentist Names
Check out these apropos real dentist names. I can believe there's actually a Dr. Daryl B Payne! And Dr. Root was a professor at my residency!
Actual Names of Practicing Dentists
Dr.Pullman, Dr.Filler, Dr.Fear, Dr.Rensch (pronounced wrench), Dr.Pick, Dr.Tusk,
Dr. Drewel (pronounced "drool"),Dr.Tucek (2thChk), Dr.Chu, Dr.Shugar, Dr.Pic,
Dr.Pang, Dr.Butcher, Dr.Harm, Dr.Hurter, Dr.Toothaker, Dr.Lynch,Dr.Root,
Dr.Nasti, Dr.Paine/Payne/Pain (15 entries but notably Dr.Daryl B Payne =
"There Will Be Pain"), Dr.Smiley, Dr.Schotz, Dr.Hale (pronounced "hell" in southern),
Dr.Bliss, Dr.Lancit, Dr.Gager, Dr. Eke
-DRS
Wednesday, January 20, 2010
Great Article on the Effects of Grinding Your Teeth
I just read this great article on the causes and effects of chronic teeth grinding. From my perspective, I always tell patients its important to address this problem early since habitual grinding can do MAJOR damage to your teeth in the long term. Usually a dentist-made nightguard will prevent this damage from occuring. Enjoy:
http://www.fox4now.com/global/story.asp?s=11738317
-DRS
http://www.fox4now.com/global/story.asp?s=11738317
-DRS
Friday, January 15, 2010
Why does my tooth Hurt? Mild Cold Sensitivity
Now that we've got tooth whitening covered, I'm going to begin a series of posts on the causes of tooth pain and sensitivity. It's important to understand these posts are meant to be informational only and are not substitutes for a formal dental exam and diagnosis. That being said, lets kick it off with mild cold sensitivity! Woo Hoo!
There are various reasons a tooth can become sensitive to cold temperature, but when you understand the basics of how a tooth is put together, you'll see they are all manifestations of the same underlying mechanism. Basically, in the center of everybody's tooth there is a soft bundle of nerves and blood vessels called the pulp. The majority (but by no means all) of dental pain comes from this pulp, and it can be very, very testy. If anything irritates these nerves in the pulp their only response is to signal pain. Hot, cold, trauma...all are interpreted as pain. They are pretty one sided in this regard. Furthermore, when something irritates the pulp, it can cause the blood vessels that compose it to become inflamed which, in turn, bothers these nerves and causes them to interpret even mild irritants as disproportionately painful. So, the pulp nerves signal pain, and the pulp blood vessels determine the tooth's threshold for pain.
Mild cold sensitivity is defined as sensitivity to cold that lasts only few seconds. If a tooth aches for a minute or longer after being exposed to something cold, something different is going on, and I'll discuss that in my next post. With that in mind, lets explore what causes mild cold sensitivity:
1) Decay - If a tooth has some decay, the proximity of the bacteria causing the decay to the center of the tooth irritates the blood vessels of the pulp which, in turn, lowers the tooth's threshold for pain.
2) Exposed root - If a tooth's root is exposed because of gum recession, the nerves of the pulp in this area are closer to the surface of the tooth and not protected by a layer of hard, insulating enamel. For this reason cold signals have a much easier time making their way to the pulp. Consequently, their effects will be exaggerated and the tooth will be sensitive. Often this sensitivity is transitory and will go away on its own -- desensitizing toothpaste can help here.
3) After a dental filling is placed - If the filling is deep and placed relatively close to the pulp, the trauma to the tooth from cleaning out all the decay can irritate the blood vessels of the pulp and consequently lower the tooth's threshold to pain. At some point in the near future (a few days to a few weeks) this sensitivity will subside.
4) Tooth has been fractured from biting on something wrong- If part of a tooth has broken off, the insulating enamel has been removed and cold sensations have a shorter distance to travel to the pulp. From there it's the the same mechanism as described in number 2 above.
5) Trauma to the tooth - If your tooth experiences blunt force trauma (through a fall, blow to the face, etc.), the blood vessels in the pulp will become irritated and lower a tooth's threshold for pain. This effect SHOULD be transitory, but tooth trauma is more complicated than this and will get its own post later.
6) Tooth is cracked - This reason is so complicated it merits its own post.
Those are the main reasons your tooth can be mildly cold sensitive. Please understand that all of these reasons require a dental consult to determine if any treatment is necessary. Think of this pain as an early warning signal that something is wrong. Often, a dentist can intervene at this stage with minor treatment. If the pain is ignored, future pain and the consequent treatment of it could be more involved. So - listen to your body and see your dentist!
Next post...strong cold sensitivity will be explained. Have a good one!
-DRS
There are various reasons a tooth can become sensitive to cold temperature, but when you understand the basics of how a tooth is put together, you'll see they are all manifestations of the same underlying mechanism. Basically, in the center of everybody's tooth there is a soft bundle of nerves and blood vessels called the pulp. The majority (but by no means all) of dental pain comes from this pulp, and it can be very, very testy. If anything irritates these nerves in the pulp their only response is to signal pain. Hot, cold, trauma...all are interpreted as pain. They are pretty one sided in this regard. Furthermore, when something irritates the pulp, it can cause the blood vessels that compose it to become inflamed which, in turn, bothers these nerves and causes them to interpret even mild irritants as disproportionately painful. So, the pulp nerves signal pain, and the pulp blood vessels determine the tooth's threshold for pain.
Mild cold sensitivity is defined as sensitivity to cold that lasts only few seconds. If a tooth aches for a minute or longer after being exposed to something cold, something different is going on, and I'll discuss that in my next post. With that in mind, lets explore what causes mild cold sensitivity:
1) Decay - If a tooth has some decay, the proximity of the bacteria causing the decay to the center of the tooth irritates the blood vessels of the pulp which, in turn, lowers the tooth's threshold for pain.
2) Exposed root - If a tooth's root is exposed because of gum recession, the nerves of the pulp in this area are closer to the surface of the tooth and not protected by a layer of hard, insulating enamel. For this reason cold signals have a much easier time making their way to the pulp. Consequently, their effects will be exaggerated and the tooth will be sensitive. Often this sensitivity is transitory and will go away on its own -- desensitizing toothpaste can help here.
3) After a dental filling is placed - If the filling is deep and placed relatively close to the pulp, the trauma to the tooth from cleaning out all the decay can irritate the blood vessels of the pulp and consequently lower the tooth's threshold to pain. At some point in the near future (a few days to a few weeks) this sensitivity will subside.
4) Tooth has been fractured from biting on something wrong- If part of a tooth has broken off, the insulating enamel has been removed and cold sensations have a shorter distance to travel to the pulp. From there it's the the same mechanism as described in number 2 above.
5) Trauma to the tooth - If your tooth experiences blunt force trauma (through a fall, blow to the face, etc.), the blood vessels in the pulp will become irritated and lower a tooth's threshold for pain. This effect SHOULD be transitory, but tooth trauma is more complicated than this and will get its own post later.
6) Tooth is cracked - This reason is so complicated it merits its own post.
Those are the main reasons your tooth can be mildly cold sensitive. Please understand that all of these reasons require a dental consult to determine if any treatment is necessary. Think of this pain as an early warning signal that something is wrong. Often, a dentist can intervene at this stage with minor treatment. If the pain is ignored, future pain and the consequent treatment of it could be more involved. So - listen to your body and see your dentist!
Next post...strong cold sensitivity will be explained. Have a good one!
-DRS
Monday, January 4, 2010
New Dental Videos
Is the written word concerning your ever-present, ever-growing dental questions not enough? Check out our website at northfordfamilydental.com and click the dental video tabs to view dental videos that answer dental questions ranging from root canals to dental implants. Of course, feel free to contact me via our Facebook page or our website if you have any questions about anything discussed in the videos.
-DRS
-DRS
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