An exposed tooth nerve occurs when the soft tissue deep inside the tooth loses its protective barrier. This central tissue, known as the dental pulp, contains the tooth’s nerves, blood vessels, and connective tissue. When the pulp is exposed to the mouth, it creates a direct pathway for bacteria, leading to inflammation and infection. Recognizing the signs of this condition is important, as it requires immediate professional intervention to prevent widespread infection and save the tooth.
Understanding the Inner Tooth Structure
The structure of a tooth consists of three main layers that protect the vulnerable pulp tissue. The outermost layer is the enamel, a highly mineralized, hard substance that serves as the tooth’s primary shield against decay and trauma. Beneath the enamel lies the dentin, a slightly softer, porous tissue that makes up the bulk of the tooth structure. Dentin contains microscopic tubules that connect to the pulp chamber, which is why its exposure can cause sensitivity.
The innermost chamber is the dental pulp, housed in the pulp chamber and root canals. The nerves and blood vessels within the pulp maintain the tooth’s vitality and transmit sensory information, such as pain. When trauma or deep decay compromises the outer layers, the pulp becomes exposed. This allows bacteria to enter and cause severe inflammation, a condition known as pulpitis.
What Exposed Pulp Looks Like
The visual appearance of exposed dental pulp is a small, distinct area contrasting with the surrounding tooth structure. This exposed area is typically seen as a pinpoint or small dot of reddish-pink tissue at the deepest part of a cavity or fracture. The color results from the dense concentration of blood vessels and soft tissue that make up the pulp. This pink or red tissue contrasts sharply with the hard, yellowish surface of the surrounding exposed dentin.
In cases of a fresh injury, the exposed pulp may appear bright red and exhibit minor bleeding or fluid weeping from the site. If the exposure is due to long-standing decay, the appearance changes dramatically as the pulp becomes infected or dies. The exposed tissue might appear darker, sometimes a dull gray or yellowish-white. This may be accompanied by a creamy or pus-like discharge. Any visible hole or fracture showing this soft tissue indicates nerve exposure.
Key Symptoms of Nerve Exposure
The symptoms of nerve exposure are typically unmistakable. The most characteristic symptom is intense, spontaneous pain that feels sharp or throbbing and can radiate across the jaw or face. This pain often occurs without external stimulus and is frequently severe enough to wake a person from sleep, indicating an inflamed or infected nerve.
Another major sign is extreme and lingering sensitivity to temperature, where discomfort persists for several seconds or minutes after the hot or cold stimulus is removed. This differs from regular tooth sensitivity, which is typically a brief, sharp jolt that fades instantly. Chewing or applying pressure can also trigger significant pain. Additionally, the gum tissue surrounding the affected tooth may become swollen, red, or tender to the touch, signaling a spreading infection.
Immediate Steps for Emergency Care
If nerve exposure is suspected, contact a dentist immediately, as this injury requires professional treatment to prevent an abscess or tooth loss. While awaiting professional care, temporary measures can manage pain and protect the exposed area from contamination. Rinsing the mouth gently with warm saltwater can help clean the area and reduce inflammation.
Over-the-counter pain relievers, such as non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, can help manage pain and swelling. To shield the nerve, the exposed site can be covered temporarily with a small piece of sugar-free chewing gum or a temporary dental filling kit product. Avoid chewing food on the affected side and refrain from consuming very hot, cold, or sugary items, which can trigger pain until the tooth is covered.