A toothache usually means that the nerve of your tooth is inflammed. In dental terms this is called ‘pulpitis’. The inflammation can be caused by a number of factors: trauma, bacterial ingression from cavities, biting pressure (clenching and grinding) or anything that irritates the nerve of your tooth. There are two types of pulpitis – reversible or irreversible. With reversible pulpitis, the nerve can become healthy again and remain vital. With irreversible pulpitis, the nerve is doomed to die.

Death of The Nerve

So what if the nerve dies, there’s no more feeling? If the nerve dies, it is a great environment for the growth of bacteria. If left alone bacteria can collect at the apex (end of the root) and cause a granuloma or a cyst. This can flare up and cause a toothache that can be more painful than the one felt with the pulpitis while the nerve was still vital.

Treatment

What is the treatment? The treatment for this is a ‘root canal’. A root canal is a procedure in which the entire nerve is removed from the tooth. The canal is cleaned out to remove as much bacteria as possible and then the canal is sealed with a  material. Antibiotics can help calm the infection down but only to a certain extent, eventually the canal must be physically cleaned out. Also the tooth can be extracted to remove the infection, this is usually the option if the tooth is broken and there is not enough structure left to place a crown or filling.