Pain in the neck of the tooth
Synonyms
Tooth neck pain
introduction
The tooth neck is the upper part of the tooth root, which connects to the tooth crown covered by the tooth enamel. While the crown is protected by the enamel, the neck of the tooth is usually covered by the gums. The gums protect the tooth neck from external influences. If this protection is lost and the tooth neck is exposed, mechanical or chemical influences can cause pain.
Read more on the topic: Tooth neck is exposed - what to do?
Illustration pain tooth neck
Tooth neck pain
a - tooth crown - Corona dentis
b - tooth neck - Cervix dentis
c - tooth root - Radix dentis
- Tooth enamel -
Enamelum - Dentin (= dentine) -
Dentinum - Tooth pulp in the tooth cavity -
Pulp dentis in Cavitas dentis - Gums -
Gingiva - Cement -
Cementum - Alveolar bone (tooth-bearing
Part of the jawbone) -
Pars alveolaris
(Alveolar process) - Nerve fibers and blood vessels
Stage of the disease:
A - D (bleeding gums -
Gingivitis -
exposed tooth neck)
Causes for an Exposed
Tooth neck:
- Decline in the gums as a result
periodontitis (inflammatory processes
within the tooth supporting apparatus)
- Age-related gum disease
- Periodontal operations for
flattening of deep gum pockets
- Improper cleaning habits
(Scrubbing, firm contact pressure,
abrasive toothpaste)
You can find an overview of all Dr-Gumpert images at: medical illustrations
Overview of causes
These causes can lead to tooth neck pain:
- Tooth decay, especially around the neck of the tooth
- untreated inflammation of the gums (gingivitis)
- untreated periodontal disease (inflammation of the teeth supporting structure)
- wrong toothbrushing technique (too much pressure, wrong "scrubbing")
- wedge-shaped defects
Causes in detail
The cause of an exposed tooth neck is either the regression of the gums as a result of periodontitis (inflammation of the gum tissue) or due to age-related gum disease. Periodontal operations to flatten deep gum pockets also expose the neck of the tooth because the upper edge of the gum is removed (Gingivectomy).
Another cause is improper cleaning habits, mainly due to "scrubbing" in connection with too much pressure and a highly abrasive toothpaste. This can also lead to a regression of the gums and an erosion of the root surface.
Read more on the topic: Proper tooth brushing
The dentin in the cervical region is traversed by numerous small root canals containing nerve fibers in which stimuli are transmitted to the pulp. By exposing the neck of the tooth, also through incorrect cleaning habits, these canals are opened and thus a connection to the irritation causing the stimulus is established. Because of the pain, there is less cleaning and the accumulation of plaque creates a vicious circle with the result that the sensitivity increases even further and dental caries occurs.
Read more on the topic: Dental neck caries
Sore throat
Inflammation of the gums (gingivitis) or the gums that hold the teeth (periodontitis) are often incorrectly described as neck inflammation. In the case of a bacterial inflammation of the periodontium, a periodontitis, however, the teeth holding apparatus are destroyed, which in the worst case can lead to the loss of the tooth. Gingivitis, on the other hand, is inflammation of the gums, which manifests itself as swelling and redness in the affected areas.
An inflammation of the neck of the tooth can colloquially mean an inflammation of the tooth pulp, a so-called pulpitis. Inflammation of the tooth nerve in the pulp is very painful. Sudden attacks of pain occur. The pain can occur on contact with food or spontaneously at night and last longer than in caries toothache. In general, it is always advisable to visit a dentist if there is pain in the neck of the tooth.
The spread of the inflammation must be counteracted to ensure that the tooth is preserved.
Read more on the topic: Tooth pulp inflammation
Cervical caries
While caries on the teeth mainly affects the chewing surfaces or the spaces between the teeth, cervical caries affects the root of the tooth. When the gums have retreated and the neck of the tooth is exposed, local caries can form very quickly on the neck of the tooth. The outermost layer on the neck of the tooth is not enamel, but rather the much more sensitive dentin. From here there is direct contact via tubules with the tooth pulp, the pulp of the tooth, in which the nerves and blood vessels are located. Therefore, those affected notice spontaneous and prolonged pain when they come into contact with cold, hot, sour or spicy foods.
In the case of dental caries, it is best to always consult a dentist directly. If a dental neck caries is not treated, there is a risk that the caries will spread to the teeth holding apparatus. In this case, inflammation, e.g. periodontitis, or in the worst case, loss of the tooth. Therefore, thorough oral hygiene with exposed tooth necks is essential.
Read more on the topic: Cervical caries
therapy
There are several ways to treat tooth neck pain. The aim of all these measures is to close the open dentinal tubules. Highly dosed fluoride gel or tooth varnish containing fluoride is applied to the sensitive regions and seals the tubules.
The patient can accompany the therapy by changing his brushing habits and thus preventing the dentinal tubules from reopening. The use of laser can also seal the openings of the tubules. The use of strontium chloride has also proven itself to combat pain. Silver nitrate can also be used to treat sensitive tooth necks, but not in the visible area as it turns black.
However, if all measures are unsuccessful, then only the sensitive area remains to be provided with a filling or an inlay.
A tooth neck filling reliably stops pain in the tooth neck and at the same time serves to treat and protect against tooth decay.
Read more on the topic: Tooth neck filling - procedure, materials, costs
Varnishes and gels have to be renewed again and again. The patient can support the dental therapy by using special toothpastes.
In addition, various dental care products are offered, with which you can take effective action against pain in the neck of the tooth and achieve relief from home. Special toothpastes, for example, contain ingredients that strengthen the tooth substance, which wrap around the exposed tooth necks and make them less sensitive after repeated use.
Which toothpaste works best?
As a measure to take at home, it is important not to over-brush the affected areas and to practice daily oral hygiene very gently. Otherwise, the gums could recede and expose more areas of the tooth neck. This leads to hypersensitivity and other associated pain. The affected areas should be treated with toothpaste containing a lot of fluoride, e.g. elmex jelly.
This can be done carefully with a toothbrush or better with a cotton swab, for example. The rest of the teeth can also be carefully brushed with a fluoride-containing toothpaste to prevent further regression of the gums.
Read more on the topic: Oral hygiene
Home remedies for tooth neck pain
In most cases, tooth neck pain can be treated well at home with simple home remedies. The daily use of fluoride-containing toothpastes ensures that a kind of protective layer is placed around the exposed tooth necks and the sensitive nerve fibers in the dentin (Dentine) thus shields against mechanical and thermal stimuli.
In the long term, this leads to a significant reduction in the perceived tooth neck pain. In addition, special toothpastes with ingredients that wrap around the tooth neck and soften the natural protective layer of the tooth enamel are clearly successful in the treatment of tooth neck pain.
Many affected patients also swear by special disinfectant oils that are available in pharmacies and various drug stores. These oils can simply be applied to the sore tooth necks after daily oral hygiene.
In addition, applying tea tree oil and / or chamomile extract can provide significant tooth neck pain relief.
In general, it is advisable for patients who suffer from exposed, pain-sensitive tooth necks to switch to a toothbrush with the softest possible bristles for oral hygiene.When choosing the right toothpaste, products with coarse or large abrasive particles, such as those found in many whitening toothpastes, should also be avoided.
This makes sense because the abrasive particles ensure that more and more of the protective tooth enamel is rubbed off and the teeth become even more sensitive to pain. Brushing your teeth should also be done with as little pressure as possible on the gums.
In order to ensure thorough dental care, special toothbrushing techniques are recommended, which can be learned in a prophylactic session at the dentist. Despite these home remedies, it is important to get to the bottom of the cause of the tooth neck pain and to treat it specifically. Home remedies of any kind cannot replace a visit to the dentist.
Symptoms
There is severe pulling pain after drinking and eating. Especially when it comes to hot or cold food and drinks. Even cold air causes severe pain. The neck of the tooth also reacts with pain to sour or sweet foods. But touch, for example with a toothbrush, is also felt to be painful. The pain disappears, but it is triggered again with every next irritation.
Pain
Tooth neck pain is not uncommon. In most cases, the gums have retreated due to various causes and now the neck of the tooth is exposed. Possible causes for a retraction of the gums can be stress-related teeth grinding at night, excessive brushing, increasing age or an inflammation of the periodontium. The gums no longer offer the underlying dentin of the tooth any protection and the small tubules in the dentin that are connected to the tooth pulp are exposed.
The pulp is the pulp of the tooth, in which nerves and blood vessels run. Therefore, the pain often occurs primarily when there is contact with cold, hot, spicy or acidic foods. The stimuli pull through the canals up to the tooth nerves and a pain that is felt as stabbing occurs. In the case of pain in the area of the tooth neck, it is generally advisable to visit a dentist. If the pain in the neck of the tooth is caused by an inflammation of the teeth holding apparatus, a so-called periodontitis, this must be treated immediately.
Summary
Tooth neck pain is the result of gum recession, which leads to an exposed tooth neck with open dentinal tubules. Thermal, mechanical and chemical stimuli lead to severe pain. Pressure can also trigger such pain. The therapy consists of the use of high-dose fluoride varnishes or gels, a laser treatment or, if these measures are unsuccessful, in fillings or inlays. The patient can support the dental measures by using suitable softer toothbrushes and controlled brushing.
