Dental neuralgia is the irritation of one of the nerves that innervate all of the oral components. It is manifested by severe pain that often affects one side of the face. Similar to electric shocks, pain occurs during certain stimuli as trivial as brushing teeth, drinking or chewing food.

The tooth has a central organ, the pulp, which contains both blood vessels and nerves which enter the cavity through a very narrow passage. The dental pulp is not stretchable at all and is therefore very easily squeezed. At the slightest infection or rise in temperature, vasodilation occurs which increases blood flow and compresses the nerves. The latter react by sending a pain signal to the brain.

The famous “toothache”, more scientifically called pulpitis, is triggered by inflammation of the pulp. It is the same phenomenon that occurs with headaches: the skull is almost not expandable. Sometimes the pain subsides when the infection becomes chronic, but great care should be taken: if a tooth no longer hurts, there is cause for concern because it may be mortification course. Insistent contact with hot or cold should normally continue to cause small pain.

The other “way” to have a toothache is through dentin, the major substance constituting the tooth. It is not vascularized but slightly innervated by tiny nerve fibrils. If you scratch at the neck of the tooth, where the email is missing, you can feel this pain.

The email and the cement are not innervated. The nerves themselves can be damaged and cause neuritis. 

There are several different pathological pains:

– The acute pulpitis, also called toothache. The pains are very violent and accelerated by cold, heat and lying down.

– The desmodontite, also called dental arthritis. The pain is more diffuse and intolerable because it does not stop. The nerve in question reacts little or nothing to temperature differences, and more to mechanical pressure or microtrauma (percussion).

– The post-extraction. It is very common that the mandibular nerve, branch of the trigeminal, is bruised, compressed or stretched during the extraction of the lower wisdom teeth. This causes pain but not paralysis, and the phenomenon is reversible (in a few days to a few weeks). 

Caries. Cavities that have not had time to reach the pulp of the tooth are easily treated and only require a simple filling. Once cleaned, the cavity is plugged with a filling or a composite.

For pulp involvement, devitalization and tooth extraction may be necessary. A dental prosthesis will then be placed. The pain caused by tooth decay can be relieved with paracetamol (Doliprane, Tylenol, etc.) or ibuprofen (Advil for example).

Tooth abscess. The dentist must perform the appropriate treatment for periodontitis. It devitalizes the tooth, that is to say it removes what remains of dental pulp; he cleans the canal (s) in the root (s) well and then performs the canal filling. If left untreated, an abscess of dental origin will develop and spread to surrounding tissues. Hospitalization then becomes urgent: the infection must be drained and antibiotics administered.

In the meantime, it is advisable to favor anti-inflammatory drugs which will decrease intra-tissue pressure, and analgesics to a lesser extent. Cloves and red peppers, in complementary treatments, also give good results.