As a quick recap, here's a picture of a cross-section of a tooth (if you are reading this blog in facebook, click on the extended info tab, scroll down to root canal treatment and check out the first picture in the series):
In this picture you can clearly see the the inner pulp I've discussed in my previous posts, as well as the hard enamel and dentin shell encasing it. It's this hard shell that causes the problems associated with root canal pain. As bacteria get closer and closer to the pulp via a crack or a growing cavity, this pulp, like any part of your body, exhibits the immune response of inflammation and swelling. Unlike the rest of your body, though, this swelling has nowhere to go due to the hard enamel covering and dentin. The very thing designed to protect the pulp actually becomes a prison for it. Consequently, pressure builds up inside of the tooth causing the pulpal nerves to go ballistic. This pressure can manifest itself in the following stages of pain over the course of days, weeks, or even months:
1) Mild cold sensitivity
2) Strong cold or hot sensitivity (aching for over 15 seconds after a hot or cold stimulus touches the tooth)
3) Spontaneous pain in the offending tooth or non-localized pain (an aching) in the jaw, sometimes extending up to the ear
4) Pain with chewing or biting on the tooth
5) A dull ache near the root of the tooth (below the gumline)
These numbers signify the tooth's progression from initial bacterial infection in the pulp, to pulpal inflammation, and finally to the total destruction of the pulp. The degree of pain will typically peak around numbers two or three, with the pain diminishing somewhat as the tooth enters the fifth stage. Moreover, it's important to note this is only a general guideline, so some of these stages may be skipped or occur at the same time. And sometimes a tooth may become completely infected by bacteria with no pain whatsoever!
So what does all this mean to you? If you are experiencing any of the symptoms from numbers 2-5, see a dentist immediately. Though there's a chance the pain may be related to something else, this is not something to be ignored because the pain can become intense and crippling. Once this happens, only a root canal or the extraction of the tooth can relieve the pain.
I recall reading a study on women who had experienced pain related to childbirth, pain related to cancer, and tooth pain due to pulp infection. These women were then asked to rank the pain they felt in each situation from least to most painful. Can you guess which one was consistently ranked the most painful? Surprisingly, tooth pain was ranked the most severe. With this in mind, please see a dentist ASAP if you think you may need a root canal.
Have a good one!
-DRS
