Dental Neuralgia: An Intense Toothache Not to Be Ignored

Dental neuralgia is a sharp, shooting pain that affects the nerves of one or more teeth. Often linked to a cavity, an abscess, or dental trauma, it requires prompt attention to relieve symptoms and treat the cause. Discover everything you need to know about this painful and stressful condition.

What Exactly is Dental Neuralgia?

Dental neuralgia, also known as a severe toothache, is an intense pain that originates from an inflamed or damaged dental nerve and radiates throughout the jaw, sometimes reaching the ear and temple. It most often affects the trigeminal nerve, which innervates the teeth, gums, and part of the face.

This neuropathic pain is characterized by:

• Its sudden onset, with shooting pains or electric shock-like sensations.
• Being triggered by contact with hot, cold, or chewing.
• Its high intensity, often difficult to bear.
• Its chronic nature, with attacks lasting from a few seconds to several minutes.

Dental neuralgia can affect any tooth but is more common in molars. It impacts the quality of life of patients who dread any contact with their affected tooth.

What Are the Symptoms of Dental Neuralgia?

In addition to the main pain, other signs should alert you:

• Bleeding of the gum around the affected tooth.
• Swelling of the cheek and sensitivity to touch.
• Mild fever, headaches.
• Difficulty chewing and swallowing.
• Bad breath.

If you have these symptoms, do not wait to see a dentist. Dental neuralgia is never trivial and can reveal an underlying dental pathology requiring care.

What Are the Main Causes of Dental Neuralgia?

Many dental and oral conditions can be the source of neuralgia, including:

• Deep dental cavity reaching the pulp and nerve.
• Dental abscess (root infection) or periodontal abscess (gum infection).
• Pulpitis (pulp inflammation), acute or chronic.
• Dental trauma (shock, fracture) affecting the nerve.
• Cracked tooth syndrome with pulp involvement.
• Poorly fitting filling or prosthesis creating an occlusal overload.
• Complications after tooth extraction or implant placement.
• Maxillary sinusitis of dental origin.

In rare cases, "essential" trigeminal neuralgia without an identified dental cause can mimic dental neuralgia. A thorough clinical and radiological examination by the dentist is essential to make the correct diagnosis.

Can Stress Cause Dental Neuralgia?

Stress and anxiety are factors that can worsen or trigger dental neuralgia. They increase the risk of:

• Bruxism (teeth grinding and clenching), which wears down teeth prematurely and irritates the pulp.
• Jaw and facial muscle tension, which accentuates stress on the teeth and gums.
• Poor oral hygiene and an unbalanced diet, which promote cavities and inflammation.

Stress management through relaxation techniques and psychotherapy can help prevent psychosomatic dental neuralgia.

What Are the Treatments for Dental Neuralgia?

The treatment for dental neuralgia has two objectives: to calm the pain and treat the cause.

To relieve the pain, several methods can be used:

• Analgesics and anti-inflammatories, both local (mouthwashes) and systemic (pills).
• Local anesthesia of the affected tooth and nerve.
• Natural remedies (clove, ginger, garlic) applied locally.
• Cold or warm compresses on the cheek.

In parallel, the dentist will perform the appropriate care for the cause:

• Filling a cavity after cleaning and pulp protection.
• Root canal treatment of the necrotic tooth and canal obturation.
• Drainage of an abscess with antiseptics and antibiotics.
• Occlusal adjustment of overloaded teeth with selective grinding.
• An occlusal splint in case of confirmed bruxism.
• A crown or veneer to restore a fractured tooth.
• Tooth extraction if the tooth is too damaged, followed by an implant.

Regular follow-up and check-ups are necessary after treatment to prevent recurrence.

Conclusion

Dental neuralgia is an intense pain that significantly impairs patients' quality of life. Often caused by a cavity or dental trauma, it requires a quick consultation with a dentist to identify and treat the cause.

Analgesics, anti-inflammatories, and appropriate dental care can in most cases relieve symptoms in a few days and preserve the affected tooth. Natural remedies can effectively complement medical treatment.

Prevention of dental neuralgia involves good daily oral hygiene, regular dental check-ups, and managing risk factors like stress and bruxism.

Frequently Asked Questions About Dental Neuralgia

How to recognize dental neuralgia?

Intense, shooting pain localized to one tooth and radiating to the jaw, triggered by contact with food or air, should raise suspicion of dental neuralgia. Other signs like swelling, gum bleeding, or fever may be associated.

What are the possible complications of dental neuralgia?

Untreated dental neuralgia can lead to an abscess, pulp necrosis, or even tooth loss. In rare cases, the infection can spread to neighboring tissues (sinuses, bone) and cause local or general complications.

Can dental neuralgia disappear without treatment?

Sometimes, dental neuralgia can temporarily subside if the inflammation decreases. But the pain always ends up recurring as long as the cause is not treated. Only appropriate dental treatment provides a lasting cure.

How to relieve dental neuralgia while waiting for the dentist?

Apply cold or warm compresses to the cheek, gently massage the gum with clove oil or an anesthetic gel, take an over-the-counter pain reliever like acetaminophen or ibuprofen. Avoid chewing on the painful side.