Skip to main content

Dental Pain, Etiology, Pathogenesis, and Management

  • Reference work entry
Encyclopedia of Pain
  • 80 Accesses

Synonyms

Dentin sensitivity; Pulpalgia; Pulpitis; Toothache

Definition

A noxious experience that originates or appears to originate from a tooth.

Characteristics

Pain is not experienced from an entirely healthy tooth under normal physiological conditions, but can be induced by a cold stimulus at 0 °C or below. It is more readily felt in otherwise normal teeth in which the dentin beneath the enamel of the crown or beneath the cementum of the root is exposed. Then cold stimuli will induce pain and hot or osmotic stimuli may do so. This pain is sharp and lasts only for the duration of the stimulus. If the dental pulp, the soft tissue within the dentin and responsible for its production, is inflamed, the pain to an applied stimulus will be strong, dull, and throbbing. It may continue beyond the duration of the stimulus and may be present spontaneously. As the majority of nociceptors in the uninjured pulp are inactive under normal circumstances, they can be classified as “silent.” No...

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 1,799.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 549.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Anderson, D. J., & Matthews, B. (1967). Osmotic stimulation of human dentine and the distribution of dental pain thresholds. Archives of Oral Biology, 12, 417–426.

    PubMed  CAS  Google Scholar 

  • Bowles, W. R., Withrow, J. C., Lepinski, A. M., & Hargreaves, K. M. (2003). Tissue levels of immunoreactive substance P are increased in patients with irreversible pulpitis. Journal of Endodontics, 29, 265–267.

    PubMed  Google Scholar 

  • Byers, M. R., Taylor, P. E., Khayat, B. G., & Kimberly, C. L. (1990). Effects of injury and inflammation on pulpal and periapical nerves. Journal of Endodontics, 16, 78–84.

    PubMed  CAS  Google Scholar 

  • Chattipakorn, S. C., Sigurdsson, A., Light, A. R., Narhi, M., & Maixner, W. (2002). Trigeminal c-Fos expression and behavioral responses to pulpal inflammation in ferrets. Pain, 99, 61–69.

    PubMed  CAS  Google Scholar 

  • Chiang, C. Y., Park, S. J., Kwan, C. L., Hu, J. W., & Sessle, B. J. (1998). NMDA receptor mechanisms contribute to neuroplasticity induced in caudalis nociceptive neurons by tooth pulp stimulation. Journal of Neurophysiology, 80, 2621–2631.

    PubMed  CAS  Google Scholar 

  • Cook, S. P., Vulchanova, L., Hargreaves, K. M., Elde, R., & McCleskey, E. W. (1997). Distinct ATP receptors on pain-sensing and stretch-sensing neurons. Nature, 387, 505–508.

    PubMed  CAS  Google Scholar 

  • Hargreaves, K. M., Bowles, W. R., & Jackson, D. L. (2003). Intrinsic regulation of CGRP release by dental pulp sympathetic fibers. Journal of Dental Research, 82, 398–401.

    PubMed  CAS  Google Scholar 

  • Heyeraas, K. J., & Berggreen, E. (1999). Interstitial fluid pressure in normal and inflamed pulp. Critical Reviews in Oral Biology and Medicine, 10, 328–336.

    PubMed  CAS  Google Scholar 

  • Hu, J. W., Dostrovsky, J. O., Lenz, Y. E., Ball, G. J., & Sessle, B. J. (1986). Tooth pulp deafferentation is associated with functional alterations in the properties of neurons in the trigeminal spinal tract nucleus. Journal of Neurophysiology, 56, 1650–1668.

    PubMed  CAS  Google Scholar 

  • Jaber, L., Swaim, W. D., & Dionne, R. A. (2003). Immunohistochemical localization of mu-opioid receptors in human dental pulp. Journal of Endodontics, 29, 108–110.

    PubMed  CAS  Google Scholar 

  • Matthews, B., & Vongsavan, N. (1994). Interactions between neural and hydrodynamic mechanisms in dentine and pulp. Archives of Oral Biology, 39, 87S–95S.

    PubMed  Google Scholar 

  • Melzack, R. (1975). The McGill Pain Questionnaire: Major properties and scoring methods. Pain, 1, 277–299.

    PubMed  CAS  Google Scholar 

  • Melzack, R. (1984). The myth of painless childbirth (the John J. Bonica lecture). Pain, 19, 321–337.

    PubMed  CAS  Google Scholar 

  • Michaelson, P. L., & Holland, G. R. (2002). Is pulpitis painful? International Endodontic Journal, 35, 829–832.

    PubMed  CAS  Google Scholar 

  • Mudie, A. S., & Holland, G. R. (2006). Local opioids in the inflamed dental pulp. Journal of Endodontics, 32, 319–323.

    PubMed  Google Scholar 

  • Narhi, M., Jyvasjarvi, E., Virtanen, A., Huopaniemi, T., Ngassapa, D., & Hirvonen, T. (1992). Role of intradental A- and C-type nerve fibres in dental pain mechanisms. Proceedings of the Finnish Dental Society, 88, 507–516.

    Google Scholar 

  • Puapichartdumrong, P., Ikeda, H., & Suda, H. (2003). Facilitation of iontophoretic drug delivery through intact and caries-affected dentine. International Endodontic Journal, 36(10):674–81.

    PubMed  CAS  Google Scholar 

  • Renton, T., Yiangou, Y., Baecker, P. A., Ford, A. P., & Anand, P. (2003). Capsaicin receptor VR1 and ATP purinoceptor P2X3 in painful and nonpainful human tooth pulp. Journal of Orofacial Pain, 17, 245–250.

    PubMed  Google Scholar 

  • Rodd, H. D., & Boissonade, F. M. (2000). Substance P expression in human tooth pulp in relation to caries and pain experience. European Journal of Oral Sciences, 108, 467–474.

    PubMed  CAS  Google Scholar 

  • Sessle, B. J., Hu, J. W., Amano, N., & Zhong, G. (1986). Convergence of cutaneous, tooth pulp, visceral, neck and muscle afferents onto nociceptive and non-nociceptive neurones in trigeminal subnucleus caudalis (medullary dorsal horn) and its implications for referred pain. Pain, 27, 219–235.

    PubMed  CAS  Google Scholar 

  • Yoshiyama, M., Masada, J., Uchida, A., & Ishida, H. (1989). Scanning electron microscopic characterization of sensitive vs. insensitive human radicular dentin. Journal of Dental Research, 68, 1498–1502.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Graham R. Holland .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Berlin Heidelberg

About this entry

Cite this entry

Holland, G.R. (2013). Dental Pain, Etiology, Pathogenesis, and Management. In: Gebhart, G.F., Schmidt, R.F. (eds) Encyclopedia of Pain. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-28753-4_1035

Download citation

Publish with us

Policies and ethics