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Why do I have a toothache if my nerve is dead?!

I can’t chew or drink cold or hot on my left lower molar!!! My doctor said the nerve died and that I need a root canal treatment? Then why does it hurt?

A healthy tooth has intact enamel which covers the crown of the visible part of the tooth. Right below that layer there is dentin which through millions of micro tubules connects to the pulp space. This space is found in every tooth, some have more canals than others such as molars. The pulp tissue also commonly referred as the “nerve” is a connective Tissue that’s highly vascularized meaning that it carries the blood supply of veins and capillaries and as well as nerve endings.

It provides nourishment and hydration to dentin the cushion yellow layer that gets decayed and it’s underneath the enamel. It also has the cells in charge of generating more dentin as Protection from external forces.

Once a cavity gets formed it is usually due to demineralization of the enamel structure. The acids typically come from certain foods and beverages and from the acidic bacterial byproducts that get produced as result of metabolizing the food left overs around gums and teeth.

Once a cavity starts, the perfect natural sterile isolation system of a tooth gets disrupted since bateria has access to dentin and eventually pulp chamber if the cavity is not caught On time.

Once the bacteria irreversibly infects the pulp tissue, inflammation increments, pressure builds up inside the tooth and the throbbing pain is excruciating.

A tooth can need a root canal treatment if the inflammation is irreversible or if the blood supply and nerve tissue has become necrotic or “dead”. The infection continues to get more access deep into the root structure until reaching the bone around the Apex of the tooth and then an abscess gets formed which further aggravates pain.

Antibiotics regimen and root canal treatment followed by a crown to protect brittle tooth is the standard of care.

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