When a person reports “feeling the bottom” or the end of a tooth, they are describing a distinct sensation that frequently centers around the gum line. This feeling does not originate from the root tip anchored in the jawbone, but from the vulnerable surface where the tooth meets the gums. This discomfort often indicates that the tooth’s natural protective layers have been compromised. Identifying the location and composition of this exposed area is key to understanding the underlying dental health issue.
Understanding the Anatomy of a Tooth
A tooth has two major parts: the crown, which is visible above the gum line, and the root, anchored within the jawbone. The crown is shielded by enamel, the hardest substance in the body. The root surface is covered by cementum, a thinner, softer layer.
The neck or cervical region is where the enamel of the crown meets the cementum of the root. This area is normally covered by healthy gum tissue. When gum tissue pulls away, this precise location is where the sensation of “feeling the bottom” often occurs. Beneath both the enamel and the cementum is dentin, a yellowish tissue forming the bulk of the tooth. Dentin is a living tissue, and its exposure directly causes most tooth sensitivity.
Primary Causes of Root Surface Exposure
The most frequent reason for this sensation is the physical exposure of the root surface due to tissue loss. This process, known as gingival recession, occurs when the gum margin shifts downward, revealing the root’s cementum layer. Because cementum is softer than enamel, it quickly wears away, exposing the underlying dentin.
Dentin contains thousands of microscopic channels, called dentinal tubules, that lead directly to the tooth’s nerve center. When these tubules are open, stimuli like temperature and pressure reach the nerve, causing sensitivity. Aggressive or improper brushing, especially with a hard-bristled toothbrush, can physically wear away the delicate gum tissue and cementum over time.
Periodontal disease, a bacterial infection that destroys supporting gum and bone, is a primary cause of recession. Non-bacterial factors also contribute. These include abrasion from teeth grinding (bruxism) or chemical erosion from highly acidic foods and drinks, which strip away enamel and cementum near the gum line.
Other Sensations Mimicking Root Exposure
Sometimes the feeling of structural compromise is caused by internal issues rather than exposed root tissue.
Cracked Tooth Syndrome
Cracked Tooth Syndrome involves a fracture line extending into the dentin, sometimes below the gum line. This crack often causes a sharp, fleeting pain upon biting down or when pressure is released. The temporary movement of the fractured segments irritates the pulp, which the patient interprets as an intense, deep feeling.
Periapical Inflammation
Another possibility is periapical inflammation, an infection or abscess forming at the tip of the tooth root. The resulting buildup of pus and pressure within the jawbone can cause the tooth to feel elevated or persistently throbbing, mimicking a structural issue.
Failing Restorations
A loose or failing dental restoration, such as an old crown or filling, can create a gap near the gum line. This gap allows bacteria and thermal changes to penetrate the underlying dentin, causing sensitivity or a feeling of looseness.
Next Steps and Professional Treatment
Because the underlying causes range from simple tissue loss to serious infection or fracture, professional diagnosis is necessary for appropriate care. A dentist will perform a thorough examination, including periodontal probing, bite tests, and X-rays, to distinguish between gum recession and internal pathology.
Treatment for straightforward recession involves applying desensitizing agents, fluoride varnishes, or placing tooth-colored bonding material over the exposed dentin. For advanced recession, a soft tissue graft may be recommended. This procedure transfers healthy gum tissue to cover the exposed root surface and prevent further damage. If a deep crack or infection is confirmed, treatment shifts to more involved procedures, such as a dental crown, root canal therapy, or extraction if the damage is irreparable.