A throbbing ache deep inside a tooth signals a serious problem requiring immediate professional attention. This discomfort is caused by inflammation or infection of the highly sensitive dental nerve. Permanently “killing” the nerve safely is a medical procedure performed only by a dental professional. Attempts to address this issue at home will fail and can lead to dangerous complications. The safe pathway involves seeking professional dental care to eliminate the source of pain and infection.
The Source of Pain: Anatomy of the Dental Pulp
The center of every tooth contains the dental pulp, a soft tissue responsible for the tooth’s vitality and sensation. The pulp is a bundle of nerves, blood vessels, and connective tissue housed within the pulp chamber and root canals. This tissue extends from the crown down to the tips of the roots, connecting to the body’s main systems through small openings called apical foramina.
Pain arises when the protective outer layers of the tooth—the hard enamel and the softer dentin—are breached, allowing bacteria to reach this sensitive inner core. Deep decay, a crack, or trauma can lead to pulpitis, the inflammation of the dental pulp. Because the pulp is encased in rigid walls, swelling creates pressure on the nerves, resulting in persistent toothache. If the infection is left untreated, the pulp tissue will eventually die (pulp necrosis), and the infection will spread into the jawbone.
Warning: Why Self-Treatment is Never the Answer
The desire to stop dental pain leads many to search for ways to kill the nerve at home, but this approach is dangerous and ineffective. The underlying infection is deep within the tooth structure, protected by hard tissue that household remedies cannot penetrate. Applying substances like aspirin or high concentrations of alcohol directly to the painful area is hazardous.
Aspirin placed against the gum tissue is acidic and can cause a chemical burn, resulting in a painful lesion that damages the soft tissues of the mouth. Using strong chemicals or high-proof alcohol will irritate healthy tissue without reaching the infected pulp. Self-medication only delays necessary professional treatment, allowing the infection to spread into the jawbone, face, or bloodstream, potentially leading to life-threatening conditions like sepsis. Even if the nerve pain temporarily disappears because the pulp dies, the infection continues to progress silently.
Definitive Professional Treatment: The Root Canal
The safe and definitive way to eliminate the painful nerve and save the tooth is root canal therapy, performed by a general dentist or an endodontist. This treatment is necessary when the dental pulp is irreversibly inflamed or infected. The process begins with local anesthesia and the placement of a dental dam to isolate the tooth from saliva and bacteria.
The dentist creates a small opening through the top of the tooth to access the infected pulp chamber and root canals. Specialized, fine instruments called dental files are used to remove the diseased pulp tissue, including the nerves and blood vessels. The canals are meticulously cleaned, shaped, and disinfected using antibacterial solutions to eliminate all remnants of bacteria.
Once the interior is clean and dry, the empty space is filled with gutta-percha, an inert, rubber-like material sealed with adhesive cement. This filling prevents future bacteria from entering the tooth’s internal structure. The opening is then closed with a permanent filling or a dental crown, which is placed later to protect the now-hollow tooth from fracturing. If the tooth structure is too compromised, the alternative professional treatment is extraction.
Managing Acute Pain Before a Dentist Visit
While waiting for the professional appointment, acute pain can be managed safely using targeted, short-term measures. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are often the most effective option because they reduce both pain and inflammation. Acetaminophen can be taken as an alternative or in combination with an NSAID for enhanced relief, but all medications must be used strictly according to package directions.
Applying a cold compress or ice pack wrapped in a cloth to the outside of the cheek can help reduce swelling and temporarily numb the pain. The compress should be used for 15 to 20 minutes at a time, with equal breaks in between. Rinsing the mouth gently with warm salt water can also help soothe irritated gum tissue. To avoid aggravating the nerve, avoid chewing on the affected side and limit consumption of very hot, very cold, or excessively sweet foods and drinks.