Tooth, because of its specific structure, where the dental pulp (blood vessels, nerves, lymphatic elements) located within a hard, impermeable tissue of the tooth (the dentin), the same course of pathological processes, but the outcome of the infection leads to death of the entire pulp tissue. The position of the pulp is extremely favorable for the healthy tissue, but at the occurrence of fatal inflammatory exudation (accumulation of fluid).
In this case, the internal pressure increases, which causes pain, the root opening delay occurs in the circulation, and there is no possibility of a new (collateral) blood flow. The second is a big difference, which is characterized by a tooth to other organs in the body, to a tooth that is no more vital pulp remains in its živčanoj function as there is, although significantly reduced, the possibility of feeding through parodoncija (surrounding tissue). Otherwise the dead tissue in the body or reabsorbed, or throw as sequestration, and the tooth may remain devitalno tissue and later dekompozira. In this case, through the small opening at the tip of the root, can breakdown products, bacteria or their toxins penetrate into the space around the root apex (periapical) and expand it in distant organs of the human body. There is a difference between the pulp and other bodies in setting an accurate diagnosis. Objective can be determined by necrosis or gangrene of the pulp and chronic inflammation with an open pulp chamber (the space in the crown of the tooth where the nerve is located), while for other damage or pulp tissue disease diagnosis is based largely on subjective symptoms of patients who are on a case by case very different.
Inflammation of every organ, including the dental pulp, has all the characteristics of the process, and the patient is the most important feeling of pain, which occurs as a reaction to the big brain tissue pressure due to increased blood flow and stop the circulation through the hole in the tip of the root. Because the inflammation in the pulp, where the open space where it is located, because of the possibility of drainage of excess fluid, and thus a reduced pressure in the tooth, and reduced pressure on the nerve elements, and thus the pain.
Why have a toothache with no apparent defect? The answer to that question is often hard to come without a detailed inspection. Usually there is a fine enamel cracks, her bare neck or demineralization of teeth due to gum withdrawal, and during the intake of food or drink possible stimulation of dentine penetration of these particles to it. How dentin contains nerve endings of tooth and the nerve is no ability to distinguish stimuli (sweet, salty, hot, cold), but still feeling pain response, we are talking about dentinskoj pain.
A tooth that is overloaded because of premature contact with the teeth of opposing jaws, or the holder of a prosthetic device, primarily because of changes in the tissues around it, and then the inside of the consequences of its pulp, may make the painful symptoms.
If you are provoked to such short-term and the pain does not respond, and then another reversible changes in the pulp, they will go into irreversible. Further treatment is removal of the pulp, or, for large changes in the tissues at the tip of the tooth root, extraction of such teeth.
Inflammation are painful
Changes in the tissues surrounding the root tip (granuloma) without chronic pain processes, and if there will be disallowed and the transition to acute, there will be pain. Initially, these pains are less intense, but you can boost the pressure tapping on the tooth. The patient feels that he has extended the tooth. The pain also increases when the patient's head in a horizontal position. Cooling of the teeth and areas around the pain decreases. The development of inflammatory pain increases, it becomes pulsating, a tooth is sensitive to touch and tongue. At this stage it is manure, which is located around the root tip, drop through the root canal tooth or the surrounding tissue (penestracija). Of course, one of the solutions and the extraction of teeth. Indeed, it should always prefer when it is expected to heat up the process, or when the process may extend into the surrounding bone or soft tissue. Extraction of this tooth is the best treatment, because it removes the cause of infection and ensure the drainage of pus through the alveoli (the wound).
Similar symptoms, and bacterial flora, meet the acute and subacute parodontopija (diseases of the supporting tissues of teeth). Periodontal disease as a chronic process, but in the neglected and untreated cases, and poor oral hygiene being closed gingivnih pockets. Special affinity with the eruption of vertical bone pockets that are easy to close and keep the infection occurs. And there is no pain that can be very intense and pulsating. The patient feels that the tooth is extended, a touch-tapping and is very painful. It is important to emphasize that the tooth can be completely healthy and vital. Treatment consists in opening or complete removal of such pockets.
For teeth that are not fully grown (wisdom teeth), there is a similar picture as in periodontal disease, just as the gingival pocket around the tooth crown is present and signs of inflammation of the gums, but not the pain of the teeth. The pocket should be emptied, and if infection penetrates deeper, there are also symptoms of stop teeth, to act with antibiotics and analgesics, and radical surgery (tooth extraction), because the infection can spread into surrounding areas.
All of inflammation which is the source of a tooth or spreading the infection is usually confined to the area around the tooth, which is manifest as acute, chronic, or transferred to, or is temporarily heal. If the defense forces of the body, assisted therapy, does not limit the process, the manure will penetrate through the bone on its surface and nadignuti periosteum and will occur subperiostalni abscess, with particularly intense pain. Further passage of pus under the periosteum of the mucosa, submucosal abscess occurs (parulis), which is less painful, and often occurs fistula (hole) through which the mucosa is running out pus, or the process is gradually withdrawn.
Pain after tooth extraction is a unique and under-understood phenomenon. It was noted that it occurs during heavy lifting, trauma due to the larger alveoli. They are also more pronounced pain during the inflammatory process, which is explained by spreading infection from the alveoli into its surroundings.Insufficient or inadequate nutrition, especially vitamin E and D and calcium and phosphorus, are among the predisposing elements. Certainly, pain after tooth extraction occurs for three reasons:
First when the blood clot is formed after the extraction,
Second clot formed when waste,
Third when the blood clot becomes infected and purulent apart.
In all three cases the mechanism of pain is the same. Broken nerve endings are exposed to external mechanical, chemical and thermal stimuli or bacterial toxins podraženi. Treatment is done cleaning the rest of the clot, causing bleeding and fresh by creating a new clot. In addition, in severe pain can be inserted into the socket of the cleaned some of the medications to reduce pain and prevent infection.