“The Death of a Tooth”: Why toothache hurts so much

“The Death of a Tooth”: Why toothache hurts so much

Dental Monthly

By Dr. Elena Speranza Moll

🦷 Drama: “The Death of a Tooth”

The part Shakespeare forgot to write and based on the true story of “Why toothache hurts so much”

The answer lies in the fact that teeth are highly innervated sensitivity structures both on the inside and in their outer surroundings.

Can’t we distinguish a tiny hair in our mouth, and don’t we yelp as we accidentally bite on a small stone in our salad? Indeed we can, and we do. This is due to the highly sensitive fibres that attach the tooth to the bone in which the tooth is floating, supported by a little trampoline of fibres. But it is not what creates the first awful pain we feel in the beginning of toothache.


“The Death of a Tooth”

played by Tooth, Nerve, Bacteria, Brain, Blood and Body



Toothache is usually caused by a cavity (…remember Ma Baker & her Sons from the October ’21 Dental Monthly). Bacteria, acids and toxins in the cavity are always moving directly to the centre of the tooth where it is softer and….where Nerve lives. This is the feast-dish they are after and cannot wait to devour. Nerve gets kind of nervous sensing their arrival, but all it can do is send small recurrent shout-outs to Brain:

“HELP they’re coming! HELLLLLP… they are close!!!”

These are the usual fits that precede the full-blown intense prolonged toothache. In response to this Brain sends some first-hand defence through the blood vessels and Blood starts to flow into the tooth, but this causes another problem. The tiny vessels swell up so much that they push and push Nerve towards the hard tooth walls. At this point the situation becomes really dangerous.

Friendly Fire in my own home!!




This is Nerve screaming for help because it’s completely crushed against the hard tooth structure, and these are the excruciating fits of pain caused by caries in your tooth. The rescue team sent by Brain actually becomes the major danger Nerve needs to overcome.

In any other part of your body, tissues have room to swell and nerve-ends can go with the flow. You know the bump on your head when you hit the door… the bruise only hurts when you touch it. In Tooth, although your Body’s reaction is exactly the same,  Nerve has no place to go and is actually smashed by Blood flowing in, which seems unable to leave and on the contrary gets increasingly abundant, and Nerve, conscious of the approaching end, surrenders and prepares ….to die.



Suddenly Tooth does not hurt anymore!!!… and happily chews away as nothing ever happened. This is usually the point when Body arrives in the Dental chair. The symptoms have disappeared, but if treatment is not sought, what happens next is even worse….

Battered Nerve is barely alive. Painkillers have relieved the swelling, but  Bacteria’s party has started and they are feasting on Nerve. Half-eaten and torn apart it has given up and doesn’t cry out anymore. Bits of decomposing Nerve are thrown out of Tooth at the tip of the root where the surrounding bone recedes immediately. Brain warned by Blood again thinks:

“Never a dull moment with Tooth!!”

And as usual sends in some first aiders with Blood that respond ASAP and create swelling at the tip of the root in an attempt to get rid of the rubbish that has accumulated there. This pushes the tooth out of its socket and once again we have PAIN!!!



This time Tooth, suffers differently. His trampoline fibres hurt so bad because the colliding teeth hit and bash against him way too soon and way too hard.

Tooth can’t stand it anymore and becomes UNTOUCHABLE. An unbearable situation and very difficult to anesthetize and to treat……

All this happens prior to any swelling of the cheek and is so much worse than anything that was felt before.

Brain, fed up with recurrent problems in the mouth, convinces Body

“It’s time to make some decisions….

Believe me take out the tooth, EXTRACTION!!”

and this is what the Body-patient, having suffered so much, will request…                                                                       

The End


Lessons to be learned:

1/ With pain, any kind of pain GO TO THE DENTIST!!… even if the symptoms diminish.

2/ When you have excruciating pain, try a No-Pain Laser-assisted approach, available in my Clinic. The necessary treatment can be performed without actually touching the tooth.


Refer to former Dental Monthly articles on Inflamm-Ageing, No Pain Laser treatments, and Sugar, the Root of all evil.

By Dr. Elena Speranza Moll,

Studio Moll
Via Amilcare Ponchielli 21B, 50018 Scandicci –Firenze
Tel: 055-755347
WhatsApp: 331-6362682


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