Nothing grabs your attention like a sharp tooth pain, seemingly hitting you out of nowhere while you’re eating or drinking. But there is a reason for your sudden agony and the sooner you find it out, the better the outcome for your oral health.

To understand tooth sensitivity, we need to first look at the three layers of tooth anatomy. In the center is the pulp filled with blood vessels and nerve bundles: it’s completely covered by the next layer dentin, a soft tissue filled with microscopic tubules that transmit sensations like pressure or temperature to the pulp nerves.

The third layer is enamel, which completely covers the crown, the visible part of a tooth. Enamel protects the two innermost tooth layers from disease and also helps muffle sensations so the tooth’s nerves aren’t overwhelmed. The enamel stops at about the gum line; below it the gums provide similar protection and sensation shielding to the dentin of the tooth roots.

Problems occur, though, when the dentin below the gums becomes exposed, most commonly because of periodontal (gum) disease. This bacterial infection caused by dental plaque triggers inflammation, which over time can weaken gum tissues and cause them to detach and shrink back (or recede) from the teeth. This can leave the root area vulnerable to disease and the full brunt of environmental sensations that then travel to the nerves in the pulp.

Tooth decay can also create conditions that cause sensitivity. Decay begins when certain oral bacteria multiply and produce higher than normal levels of acid. The acid in turn dissolves the enamel’s mineral content to create holes (cavities) that expose the dentin. Not treated, the infection can eventually invade the pulp, putting the tooth in danger of being lost unless a root canal treatment is performed to remove the infection and seal the tooth from further infection.

So, if you begin experiencing a jolt of pain while eating or drinking hot or cold foods or beverages, see your dentist as soon as possible to diagnose and treat the underlying cause. And protect your teeth from dental disease by practicing daily brushing and flossing, as well as seeing your dentist for regular dental cleanings and checkups. Don’t ignore those sharp pains—your teeth may be trying to tell you something.

If you would like more information on tooth sensitivity, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Treatment of Tooth Sensitivity.”

As with the rest of the body, tooth pain is an indication that something’s wrong. While the exact cause requires a dental exam, the location, quality and duration of the pain could narrow the possibilities. With that in mind, here are 3 types of tooth pain and what it might be telling you.

Sensitivity. Pain or discomfort when you eat or drink cold foods or bite down could mean you have a small area of decay in the tooth, a loose filling or an exposed root surface from gum recession. Dental work to repair a decayed tooth or filling could alleviate the pain; in the case of gum recession, you may need to reduce overaggressive brushing or seek treatment for periodontal (gum) disease, the two main causes of the condition.

Dull or lingering pain. A dull ache in the rear sinus area could indicate a problem with a back tooth — they share the same nerve pathways as the sinuses, so you may be feeling referred pain. In the case of lingering pain after eating or drinking something hot or cold, there may be decay within the inner pulp chamber of the tooth that’s damaging or even killing the nerve tissue. If so, a root canal treatment might be in order.

Sharp pain. That sudden, excruciating pain when you bite down could mean you’re experiencing advanced decay, a loose filling or possibly a cracked tooth. If the pain seems to radiate from the gums — and they’re swollen and sensitive — you may have developed an abscess brought on by periodontal (gum) disease. In all these cases, appropriate dental treatment like decay removal and filling, root canal treatment or plaque removal may be necessary, depending on the cause and extent of the problem.

Regardless of what kind of pain you’re feeling, you should see us as soon as possible — in many situations waiting will only make the problem worse. The sooner we discover the cause, the sooner we can begin the right treatment to solve the issue and alleviate your pain.

If you would like more information on the causes and treatment of tooth pain, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Pain? Don’t Wait!”

A toothache means you have tooth decay, right? Not necessarily — your pain could be signaling a number of potential causes. Determining where, how much and how often it hurts will help us find out the cause and apply the appropriate treatment.

A single symptom, for example, can mean many things. A twinge of tooth pain as you consume hot or cold foods might indicate localized tooth decay easily repaired by a filling. But it could also mean the tooth's root surface has been exposed as a result of periodontal (gum) disease — aggressive plaque removal and maybe even gum surgery might be necessary. Or it could be a sign of inner pulp decay: in this case you'll likely need a root canal treatment to save the tooth.

Pulp decay can also announce itself with a very sharp and constant pain radiating from one or more teeth. You shouldn't hesitate to see us for an examination — even if the pain goes away. Pain cessation most likely means the nerves in the pulp have died. The infection, however, still exists, so you'll still probably need a root canal treatment.

If you notice severe, continuous pain and pressure around a tooth, particularly about the gums, you may have a localized, inflamed area of infection called an abscess. An abscess can be the result of gum disease, but it might also stem from a foreign body like a popcorn husk, getting stuck below the gums. We'll need to conduct a complete dental examination to determine the cause and how to treat it.

Finally, a sharp pain when you bite down could mean many things such as a loose filling or a fractured (cracked) tooth. The latter especially requires immediate attention to save the tooth.

These are just a few of the possible causes behind mouth or facial pain. Although all of them are serious, a few are true dental emergencies and can't wait if we're going to save a tooth. The sooner you see us, the sooner we can help relieve the pain, minimize any damage and avert disaster.

If you would like more information on treating tooth pain, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Pain? Don't Wait!”

Dr. Arauz received his first dental degree (Doctor in Dental Surgery, D.D.S.) from the University of Panama in Panama City, Panama in 1997 and then his second dental degree (Doctor in Dental Medicine, D.M.D.) from Case Western Reserve University School of Dental Medicine in Cleveland, Ohio in 2004. He completed his specialty degree in Periodontology at the University of Rochester’s world-renowned Eastman Dental Center in New York in 2002, and completed a two-year residency in advanced education in general dentistry (AEGD) and general practice residency (GPR) as well. While at Case Western Reserve University, he was an Assistant Professor in the Department of Periodontics and he taught to residents and dental students for five years. He was also Clinic Director of the residency in Periodontics, and directed courses in Implantology, Sedation, and Surgical Periodontics. Additionally, Dr. Arauz was a staff periodontist and consultant in periodontology and dental implants at the Department of Dentistry of the world-renowned Cleveland Clinic, and practiced periodontics and dental implantology in private offices located in Westlake, Lyndhurst and Mentor, Ohio. Dr. Arauz is a Board Certified periodontist, Diplomate of The American Board of Periodontology, and an active member of the American Academy of Periodontology, the Academy of Osseointegration and the American Board of Periodontology. The dental practice of Dr. Jose Arauz is limited to Periodontics, Implants, and Oral Medicine. He is fluent and proficient in English, Spanish and Portuguese.

Dr. Jose I. Arauz - Jacksonville's Dental Implant Specialist. The Expertise You Need. The Care You Deserve. 

Although toothaches are common, not all tooth pain originates from the same source. But regardless of its cause, you need to take prompt action to find out and begin treatment.

Sensitive teeth, for example, usually cause a quick stab of pain when you eat or drink something hot or cold or when you bite down. If the pain lasts only a second or two, you may have a small area of decay in a tooth, a loose filling or an exposed root. The latter often occurs either because of over-aggressive brushing or periodontal (gum) disease. In both cases, the gums may have shrunk back or receded to expose the root surface.

A sharp pain when biting down may be a sign of decay or a loose filling; it could also mean you have a fractured or cracked tooth. For any of those causes, you'll need treatment to repair the problem and relieve the pain.

You may also experience a lingering tooth pain ranging from dull to sharp, or localized to one tooth or seeming to radiate from a general area, such as above the upper jaw. There are a number of possible causes, but two prominent ones are an abscess (a localized area of infection that's become inflamed) or deep decay within the pulp, the heart of a tooth.

This usually calls for a root canal treatment for the affected tooth. In this procedure we drill an access hole into the pulp and clear it of infected and dead tissue. We then fill the empty pulp chamber and root canals with a special filling and seal the access hole. Later, we bond a permanent artificial crown to the tooth to further protect it from re-infection.

Whether your pain is momentary or lingering, dull or sharp, you should see us as soon as possible to determine its cause. You should still see us even if sharp, lingering pain goes away — this could simply mean the infected nerves in the pulp have died but not the infection. The sooner you have the cause of your pain treated, the better your chances of a happy and less costly outcome.

If you would like more information on tooth pain and what to do about it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Pain? Don't Wait!”