4 www.pagd.org Ow, doc! My tooth you worked on hurts! Who doesn’t love to hear this? As an endodontist, this is part of the picture of pulpal breakdown/disease that we see all the time. My goal is to help you predict tooth pain and prevent the above comment. There are two main components to tooth pain: bacteria and inflammation. Obviously, without bacteria no painful abscesses would happen, but what about inflammation? A researcher out of Italy1 has performed histologic analyses of different stage of pulpal breakdown—reversible pulpitis, irreversible pulpitis, and necrosis—and uncovered some patterns. Now obviously every situation is unique, but general patterns are important for a conceptual understanding. This is what I aim to convey. First of all, inflammation is consistent throughout the body to varying degrees, with signs of redness, swelling, heat, and pain. I want to give an analogy that we can all understand—a scratch. Imagine if you will you bump up against a sharp corner and scratch your skin. The scratch will become red, swollen, hot, and painful and is a sign of inflammation. If the scratch is minor, the skin doesn’t break, bacteria doesn’t get in, and the inflammation can reverse to normal (think reversible pulpitis). If the scratch is severe, the skin breaks, bacteria gets in, and infection can develop. This would be analogous to irreversible inflammation leading to an abscess in a tooth. When a patient develops pain, first think of this as a sign of inflammation. Play the ‘find the inflammation’ game. See By Brett Cole, DMD SCRATCHING THE SURFACE Diagnosing Pain in a Way Patients Can Understand Q dentistry issues
RkJQdWJsaXNoZXIy MTY1NDIzOQ==