If you have experienced such pain that you are not sure which tooth hurts you – because the whole side hurts, and the sinuses, and the ear, and the head – there is a high chance that you have a pulp toothache. The pulp is the most vital part of the tooth, it is the soft tissue in the root of the tooth that contains the nerve, blood vessels and connective tissue. When it becomes infected or damaged, the dentist will recommend nerve removal and try to stop further tooth decay.
What is the nerve of the tooth and where is it located?
The dental nerve is a generally accepted name for dental pulp, although, in addition to the nerve, the pulp also consists of lymph vessels, blood vessels and connective tissue. This is the softest and most vital part of the tooth, which not only makes its core but also makes the tooth alive. In the area of the tooth crown, it is located in the pulp chamber, while in the area of the root in the root canal of the tooth.
The pulp, with all blood vessels, connective fibres and nerves, is protected from bacterial attack and infection by a layer of dentin. Dentin is the largest part of the tooth and small nerve endings pass through it, which can actually give a signal – if caries develops on the enamel.
Enamel is the hardest part of the tooth and is also the hardest tissue in the entire human body. However, it deteriorates and how it can occur, if oral hygiene is not carried out properly and regularly. Caries can progress and reach the dentin. Dentin is a softer tissue than enamel, so the path of deterioration to the dental pulp and nerves is much faster.
When is it necessary to extract a nerve from a tooth?
Root canal treatment is also called endodontic therapy, and it involves removing the infection from the tooth and removing the dental nerve. Although nerve removal sounds like a painful process at the very mention, thanks to anaesthetics, this is a painless therapy. When is it necessary to access it?
Infected tooth and pulp – deep caries
When caries spreads from the enamel to the dentin and reaches the pulp, it is necessary to stop the infection and to prevent its spread to the surrounding tissues, such as the alveolar bone, for example. Then the treatment of the root canal, where the pulp is located, is started. Caries that has affected all the dental tissues is called deep caries.
It often happens that out of fear of visiting the dentist, a person ignores toothache or when that is impossible – he calms the pain with the help of analgesics. The toothache passes in that way, the pain stops, so the person thinks that he has solved the problem. However, that cannot be further from the truth.
The process that started in the tooth will not stop on its own. If the infection is not treated, the pulp dies, ie the tooth gangrene. Gangrene, in addition to the unbearable pain that comes back, is accompanied by inflamed gums and bad breath, and the tooth changes its colour. Treatment is slow, and if it is not started on time, it can be without success, which unfortunately results in tooth extraction. Read more about gangrene here.
A dead or non-vital tooth is nothing but a tooth whose nerve is dead. Regardless of what caused the death of the dental pulp, the treatment of the root canal is approached immediately. Extraction of the tooth nerve is the only way to prevent the spread of bacteria to the surrounding teeth and gums.
Trauma or tooth fracture
If a tooth fracture occurs, it can happen that the fracture spreads deep into the tooth and reaches the pulp. In this case, it is necessary to perform nerve extraction.
Also, when there is some trauma, and a lot of pressure is put on the tooth, there is a possibility that the nerve ending will be cut off. This will result in nerve death and is an indication of nerve extraction. What is unusual about trauma and its effect on the pulp is that nerve death can occur immediately or even years after the injury occurred.
Tooth root resorption
One of the reactions to trauma or tooth transplantation may be root resorption when the tooth structure dissolves. If the damage starts on the outside of the root and moves inwards, it is called external root resorption. If a tooth dissolves from the middle or inside of the tooth and progresses to the outside, it is classified as internal resorption. In both cases, resorption can attack the pulp canal and the vital nerve and blood vessels that are in it.
Does nerve extraction hurt?
Patients are mostly most concerned about pain during nerve removal. However, with the use of an adequate anaesthetic, this treatment is relatively painless.
The pain after removing the nerve that the person complains about and feels does not come from the treatment, but from the infection. The treatment does not cause pain, but on the contrary, helps to alleviate it.
It is quite certain that after the therapy, the tooth will be more sensitive to pressure and irritation for some time, but it is possible to alleviate the pain with medications that can be bought in pharmacies without a prescription. If he deems it necessary, the dentist may prescribe an antibiotic.