The intense discomfort of an exposed tooth nerve signals a serious dental emergency. This condition, characterized by severe, sharp, or throbbing pain, means the highly sensitive inner tissues of the tooth are vulnerable to the outside environment. When the protective layers of the tooth are breached, the nerve is irritated by temperature changes, air, or bacteria, causing debilitating pain. Seeking professional dental care immediately is the only way to effectively stop the pain and prevent a small problem from becoming a life-threatening infection. Ignoring this condition risks the integrity of the tooth and overall health.
What Constitutes an Exposed Nerve
The “nerve” within the tooth is the dental pulp, a soft tissue encased in the pulp chamber containing blood vessels, nerves, and connective tissue. This pulp is normally shielded by the hard enamel and the softer dentin beneath it. When this protective barrier is compromised, the pulp is exposed to the oral environment, resulting in intense pain. Exposure commonly occurs due to deep, untreated decay or physical trauma. Cavities or fractures allow bacteria to reach the pulp chamber, leading to inflammation and infection of the nerve tissue.
The Risk of Placing a Temporary Filling
Placing a standard, over-the-counter temporary filling directly onto an exposed nerve is dangerous. The primary risk is that the non-sterile material seals existing bacteria inside the pulp chamber, accelerating the inflammatory process known as pulpitis. An improperly placed filling can also create direct pressure on the inflamed pulp tissue, worsening the severe pain.
Materials in at-home kits are designed for sealing a lost filling or protecting dentin, not for contact with delicate pulp tissue. These materials do not promote sterile healing and break down quickly, leaving the nerve more vulnerable.
A professional may use a temporary medicated filling in a deep cavity to calm a sensitive nerve, but this is done under sterile conditions and is not a direct pulp exposure. Attempting a DIY filling when the pulp is visibly exposed risks turning a salvageable tooth into one requiring immediate root canal therapy or extraction due to a sealed-in abscess.
Immediate Steps for Pain Management
Since placing a temporary filling is ill-advised, focus on temporary pain relief until professional care is available. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, help manage discomfort and reduce inflammation. Follow dosage instructions strictly and avoid placing aspirin directly on the gums or tooth, as this can cause a chemical burn.
Gently rinsing the mouth with warm salt water helps clean the area and reduce inflammation. Mix a teaspoon of salt into warm water and swish for about 30 seconds. Applying a cold compress or ice pack to the outside of the cheek for 15 to 20 minutes can also help constrict blood vessels and numb the pain.
To prevent further irritation, avoid chewing on the affected side and keep hot or cold foods away from the area. If a sharp edge of the broken tooth is cutting the cheek, use a small piece of dental wax or sugar-free gum to cover the edge sparingly. These measures provide short-term comfort but do not treat the underlying issue, emphasizing the need for immediate dental attention.
Clinical Treatment for Pulp Exposure
Treatment for an exposed pulp depends on the extent of the damage, the size of the exposure, and the health of the nerve tissue. The dentist assesses the pulp’s viability to determine if it can be saved or if it is irreversibly infected. This assessment dictates the two main professional treatment paths: pulp capping or root canal therapy.
Pulp capping is preferred when the exposure is minimal, such as from trauma or accidental exposure during a procedure, and the pulp is healthy. The dentist places a specialized, biocompatible material, like Mineral Trioxide Aggregate (MTA) or calcium hydroxide, directly over the exposed nerve tissue. This material acts as a barrier, stimulating the pulp to form a new layer of protective dentin, sealing the exposure and preserving the nerve’s vitality.
If the pulp is infected, severely inflamed, or non-vital, root canal therapy is necessary to save the tooth. This procedure involves removing the entire infected pulp tissue from the chamber and root canals. The cleaned canals are disinfected and sealed with a rubber-like material, and the tooth is then restored with a permanent filling or a crown. In rare cases where the tooth is too compromised, extraction may be the last resort.