Either decay in a tooth or leakage from around a restoration causes the dental pulp (nerve) to become inflamed. Such a tooth can be painful, especially to temperature changes, pressure from biting, touching the tooth, or sometimes the pain is spontaneous. If the episodes of pain have been present for days, is severe or continuous, then most probably the tooth is suffering from an irreversible pulpitis. Root canal treatment for these teeth. (Go to Root Canal Treatment)
When the dental pulp (nerve) inside the tooth dies then the space inside the roots (root canals) will inevitably become contaminated by bacteria. The bacteria in root canals will leak out the end of the root causing an abscess. This may occur rapidly within days, or it may be slow taking a year or longer for an abscess to appear.
The symptoms from a tooth like this may vary from severe pain, swelling of the face, systemic illness including a fever, difficulty in swallowing, to no symptoms at all other than a draining point beside the tooth. Dental infections are a major cause or hospitalisation and need to be thoroughly investigated and treated.
Sometimes a tooth has already received a root filling but the inside of tooth has not been cleaned adequately or the root filling and/or the restoration is leaking. These teeth can also develop a dental infection. (Go to either Root Canal Treatment or Root Canal Retreatment).
Teeth getting a knock (trauma) may cause a piece of tooth breaking away, to a tooth being knocked out completely out of its socket position, around teeth, in more severe cases a broken jaw. Usually the hospital will take care of more severe injuries but a general dentist will see the common problems.
Complications that may require further care are an exposed pulp ( exposure of the nerve in the tooth), to pulp necrosis (the nerve inside the root dying) which may cause a dental infection. An avulsed tooth, a poorly positioned tooth, or complications of the attachment of the root to the bone (periodontal complications), or an abnormal attachment of the root to the bone (ankylosis) can all be complications of dental trauma.
The treatment available to these problems range from respositioning the tooth in the correct position, to root canal treatment, to replacement of a missing tooth (Go to Root Canal Treatment or Pulpotomy, or Dental Implant).
When a restoration (filling) is placed into a tooth then one corner or more may move independently when biting on the tooth. Not very commonly, this also occurs in a tooth with no restorations. The common complaint is a sharp pain when biting on hard food. This pain usually lasts only when biting down or releasing the bite. Sometimes a cracked tooth may cause irreversible pulpitis (an inflamed nerve) or even pulp necrosis (a dead nerve inside the roots).
These cases with require either root canal treatment or extraction. ( Go to Root Canal Treatment or Dental Implant).
Like other areas of the body, long lasting pain can affect the mouth with the muscles of the jaw may also be contributing to this pain. Often the pain is not related to any particular damaged or diseased tissue.
It is important to eliminate inflammation or infections around teeth as a source of this pain. It is also important to avoid doing unnecessary treatment on teeth in the hope that this will resolve chronic pain as it may make it worse. There are other dental specialists who may manage this type of pain, but it is important to eliminate other possible causes of this pain. (See picture of healthy tooth).